Doppler energy: A new acquisition technique for the transthoracic detection of myocardial perfusion defects with the use of a venous contrast agent

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Aims: This animal experiment was designed to study whether the new technique of Doppler energy imaging could display myocardial perfusion abnormalities with the use of a combination of transthoracic imaging and right atrial injection of a myocardial contrast agent.

Methods and Results: A series of 11 pigs were studied during (1) normal perfusion, (2) dipyridamole-induced coronary dilatation, and (3) during and after temporary occlusion of the left anterior descending or circumflex artery after a right atrial injection of 8 ml Levovist, 400 mg/ml. Short-axis views were obtained with the four following imaging modes: gray scale imaging (two-dimensional and M-mode), Doppler energy imaging (two-dimensional and M-mode). Visual inspection and off-line video densitometry (results expressed in arbitrary videointensity units 0 to 255) with digital background subtraction were performed. Doppler energy was significantly more sensitive in detecting the presence of contrast than gray scale imaging (background subtracted peak videointensity 32±17 versus 17±12, p<0.001). Mean background-subtracted videointensity increased during dipyridamole-induced coronary hyperemia (40±14 versus 31±9, p<0.003) using Doppler energy technique. Doppler energy imaging consistently detected absent perfusion (background subtracted videointensity −6±6) and immediate reperfusion (background subtracted peak videointensity 29±15, p<0.001). Conclusions: With the use of a galactose-based contrast agent, Doppler energy data acquisition was superior to standard gray scale imaging in transthoracic evaluation of regional myocardial perfusion, absence of perfusion, and reperfusion.

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