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Titolo:
Effects of acute myocardial ischemia on intramyocardial contraction heterogeneity - A study performed with ultrasound integrated backscatter during transesophageal atrial pacing
Autore:
Colonna, P; Montisci, R; Galiuto, L; Meloni, L; Iliceto, S;
Indirizzi:
Univ Cagliari, Inst Cardiol, I-09124 Cagliari, Italy Univ Cagliari Cagliari Italy I-09124 st Cardiol, I-09124 Cagliari, Italy
Titolo Testata:
CIRCULATION
fascicolo: 17, volume: 100, anno: 1999,
pagine: 1770 - 1776
SICI:
0009-7322(19991026)100:17<1770:EOAMIO>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; TWO-DIMENSIONAL ECHOCARDIOGRAPHY; TISSUE CHARACTERIZATION; INFARCTION; PERFUSION; DOG;
Keywords:
coronary disease; echocardiography; pacing; ischemia; myocardial contraction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Colonna, P Univ Cagliari, Inst Cardiol, Via Osped 46, I-09124 Cagliari, Italy Univ Cagliari Via Osped 46 Cagliari Italy I-09124 liari, Italy
Citazione:
P. Colonna et al., "Effects of acute myocardial ischemia on intramyocardial contraction heterogeneity - A study performed with ultrasound integrated backscatter during transesophageal atrial pacing", CIRCULATION, 100(17), 1999, pp. 1770-1776

Abstract

Background-Subendocardial thickening is greater than subepicardial thickening and acute myocardial ischemia mainly impairs the former. Integrated backscatter cyclic variations (IBScv) reflect regional myocardial contractility and are blunted during myocardial ischemia. We hypothesized that stress-induced myocardial ischemia mainly affects subendocardial IBScv. Methods and Results-Multiplane transesophageal echocardiography and simultaneous atrial pacing were performed in 12 patients without coronary artery disease (CAD) and in 25 with significant CAD. In a transgastric 2-chamber view, we calculated IBScv in subendocardium and subepicardium and a heterogeneity index, both at rest and at peak-pacing. In 27 myocardial segments of patients with normal coronary arteries, and in 16 myocardial segments supplied by coronary artery without significant stenosis in patients with CAD, there was a transmural gradient of IBScv at rest and the heterogeneity indexdid not change during all the protocol steps. In the 53 myocardial segments related to a significantly narrowed coronary artery, the transmural gradient of IBScv, present at rest, significantly decreased at peak-pacing because of subendocardial blunting, but promptly recovered 5 seconds after pacing interruption. Moreover, the myocardial thickening at rest and peak pacingcorrelated with the subendocardial IBScv behavior and not with the subepicardial one. Conclusions-IBScv are greater in the subendocardium than in the subepicardium. Atrial pacing stress test does not affect IBScv in segments supplied by nonstenotic coronary arteries, whereas it affects segments supplied by diseased coronary arteries, blunting exclusively subendocardial IBScv. Heterogeneity of IBScv intramyocardial changes caused by stress-induced ischemia must be taken into account when using IBScv for investigating myocardial ischemia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 07:11:58