MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY FOR FOLLOW-UP AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Myocardial contrast echocardiography was performed, before and after successful elective percutaneous transluminal angioplasty [PTCA] of a main coronary artery, in 35 patients [31 men, 4 women; mean age 56 +/- 6 years]. After intracoronary injection of microbubbles-containing 2 ml iopromide, contrast half-life [t/2] and maximal echo-intensity [I[max]] in the myocardial region supplied by the target vessel were measured. While t/2 decreased from 8.3 +/- 5.4 s to 5.7 +/- 3.3 s [P < 0.0002], mean I[max] remained unchanged [27.4 +/- 10.7 vs 26.1 +/- 10.1 greyvalue units]. Repeat cardiac catheterization with contrast echocardiography was performed a mean of 37 weeks [7-53] later in 13 of 35 patients with optimal echo image quality. Re-stenosis of at least 75% was demonstrated in six patients, while in seven vessel diameter had decreased by less than 30%. In all patients with re-stenosis t/2 had increased by about 20 to 100% of the initial value. It was always over 5 s [mean 6.2 +/- 1.6 s before, 4.7 +/- 1.7 after PCTA, and 6.2 +/- 1.2 s at the end of the follow-up]. In one patient a prolonged t/2 persisted due to vessel dissection. Mean t/2 remained unchanged in patients without re-stenosis [5.6 +/- 2.1 s before, 3.5 +/- 1.15 s immediately after PCTA. and 3.6 +/- 1.25 s at the follow-up examination]. - These data suggest that contrast half-life is suitable for demonstrating changes in myocardial perfusion after PTCA.