Dr. Naresh Sen


Myocardial contrast echocardiography (MCE )can be a feasible alternative to the widely used radionuclide single-photon emission computed tomography (SPECT), which is often limited by higher costs, exposure to radiation, poor spatial resolution and frequent attenuation artefacts.MCE is useful to detect coronary artery disease on basis of myocardial perfusion. Many studies have demonstrated concordance between MCE and SPECT for assessment of Myocardial Perfusion during rest and stress. Myocardial contrast echocardiography also provides higher sensitivity as well as incremental prognostic value over and above Wall Motion  in patients with stable coronary artery diseases (CAD). Importantly, the higher sensitivity of MCE over Wall Motion is independent of the type of stress modality used.

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Kassab GS, Lin DH, Fung YB. Morphometry of pig coronary venous system. Am J Physiol. 1994;267(6):H2100-13.

Senior R, Becher H, Monaghan M, et al. Contrast echocardiography: evidence based recommendations by European Association of Echocardiography. Eur J Echocardiogr. 2009;10(2):194-212.

S. Abdel Moneim, S. V. Mankad,MM. Bernier, A. Dhoble, Ness. S. A. Hagen, K. Chandrasekaran, P. A. Pellikka, J. K. Oh, S. L. Mulvagh, 2009Microvascular function in Takotsubo cardiomyopathy with contrast echocardiography: prospective evaluation and review of literature. J Am Soc Echocardiogr. 2009;22 1249 55

S. S. Abdelmoneim, S. V. Mankad, M. Bernier, A. Dhoble, Ness. S. A. Hagen, K. Chandrasekaran, P. A. Pellikka, J. K. Oh, S. L. Mulvagh, 2009Microvascular function in Takotsubo cardiomyopathy with contrast echocardiography: prospective evaluation and review of literature. J Am Soc Echocardiogr. 2009;22 1249 55 2.

L. Agati, G. Tonti, L. Galiuto, V. Di Bello, S. Funaro, M. P. Madonna, B. Garramone, T. A. M. I. C. I. Magri, Investigators, 2005Quantification methods in contrast echocardiography. Eur J Echocardiogr 2005;6Suppl 2:S14 20 3. E.

M. Antman, M. Cohen, P. J. Bernink, C. H. Mc Cabe, T. Horacek, G. Papuchis, B. Mauntner, R. Corbalan, D. Radley, Braunwald El, 2000The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA 2000;284 835 42 4.

G. Avegeliano, M. Huguet, J. P. Costabel, R. Ronderos, B. Bijnens, P. Kuschnir, J. Thierer, C. Tobon-Gomez, G. O. Martinez, A. Frangi, 2011Morphologic pattern of late gadolinium enhancement in takotsubo cardiomyopathy detected by early cardivascular magnetic resonance. Clin.Cardiol. 2011; 34 178 82 5.

J. P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A. Fox, D. Hasdai, E. M. Ohman, L. Wallentin, W. Wijns, 2007Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 2007;28 13 1598 1660 6.

J. S. Berger, L. Elliott, D. Gallup, M. Roe, C. B. Granger, P. W. Armstrong, R. J. Simes, H. D. White, F. Van de Werf, E. J. Topol, J. S. Hochman, L. K. Newby, R. A. Harrington, R. M. Califf, R. C. Becker, P. S. Douglas, 2009Sex differences in mortality following acute coronary syndromes. JAMA 2009; 302 874 82 7.

S. M. Chadderdon, S. Kaul, Molecular imaging with contrast enhanced ultrasound. (2010 J Nucl Cardiol 2010; 17 667 77 8. N. S. Chahal, R. Senior, Clinical applications of left ventricular opacification. (2010JACC Cardiovasc Imaging 2010; 3 188 96 9. Crossman DC. 2004The pathophysiology of myocardial ischaemia. Heart 2004;90 5

Jayaweera AR, Edwards N, Glasheen WP, et al. In vivo myocardial kinetics of air-filled albumin microbubbles during myocardial contrast echocardiography: comparison with radio-labeled red blood cells. Circ Res. 1994; 74: 1157–1165.

Keller MW, Segal SS, Kaul S, et al. The behavior of sonicated albumin microbubbles within the microcirculation: a basis for their use during myocardial contrast echocardiography. Circ Res. 1989; 65: 458–467.

Wei K, Jayaweera AR, Firoozan S, et al. Quantification of MBF flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. Circulation. 1998; 97: 473–483.

Kaul S, Senior R, Dittrich H, et al. Detection of coronary artery disease with myocardial contrast echocardiography: comparison with 99mTc-sestamibi single-photon emission computed tomography. Circulation. 1997; 96: 785–792.

Wei K, Le E, Bin JP, et al. Quantification of renal blood flow with contrast-enhanced ultra-sound. J Am Coll Cardiol. 2001; 37: 1135–1140.

Villanueva FS, Glasheen WP, Sklenar J, et al. Characterization of spatial patterns of flow within the reperfused myocardium using myocardial contrast echocardiography: implications in determining the extent of myocardial salvage. Circulation. 1993; 88: 2596–2606.

Kaul S, Senior R, Firschke C, et al. Incremental value of cardiac imaging in patients pre-stenting to the emergency department with chest pain and without ST-segment elevation: a multicenter study. Am Heart J. In press.

Villanueva FS, Camarano G, Ismail S, et al. Coronary reserve abnormalities during post-infarct reperfusion: implications for the timing of myocardial contrast echocardiography to assess myocardial viability. Circulation. 1996;94: 748–754.

Ito H, Tomooka T, Sakai N, et al. Lack of myocardial perfusion immediately after successful thrombolysis: a predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation. 1992; 85: 1699–170

Ragosta M, Camarano G, Kaul S, et al. Microvascular integrity indicates myocellular viability in patients with recent myocardial infarction: new insights using myocardial contrast echocardiography. Circulation. 1994; 89: 2562–2569.

Le DE, Bin JP, Coggins M, et al. Relation between myocardial oxygen consumption and myocardial blood volume: a study using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2002; 15: 857–863.

Bin JP, Le DE, Jayaweera AR, et al. Direct effects of dobutamine on the coronary microcirculation: comparison with adenosine using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2003; 16: 871–879.

Jayaweera AR, Wei K, Coggins M, et al. Role of capillaries in determining coronary blood flow reserve: new insights using myocardial contrast echocardiography. Am J Physiol. 1999; 277: H2363–H2372.

Leong-Poi H, Rim SJ, Le DE, et al. Perfusion versus function: the ischemic cascade in demand ischemia: implications of single-vessel versus multivessel stenosis. Circulation. 2002; 105: 987–992.

Senior R, Lepper W, Pasquet A, et al. Myocardial perfusion assessment in patients with medium probability of coronary artery disease and no prior myocardial infarction: comparison of myocardial contrast echocardiography with 99mTc-SPECT. Am Heart J. In press.


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