[Evaluation of left ventricular diastolic function using velocity vector imaging and quantitative tissue velocity imaging].

OBJECTIVE: To validate the efficacy of velocity vector imaging (VVI) and quantitative tissue velocity imaging (QTVI) for evaluating left ventricular diastolic function. METHODS: Fifty-one patients underwent left heart catheterization were included in this study. Mean of peak early diastolic velocity (Em), EF and the ratio of early (E) to late (A) mitral valve flow velocity (E/A) were measured by echocardiography and the ratio of E to Em (E/Em) was calculated. Left ventricular end diastolic pressure (LVEDP) was measured during catheterization examination. RESULTS: E/Em derived from VVI or QTVI was significantly correlated with LVEDP (r = 0.808, P < 0.01 and r = 0.692, P < 0.01, respectively) and the correlation coefficient between VVI and LVEDP was significantly higher than that between QTVI and LVEDP (Z = 2.246, P = 0.025). Em derived from VVI and QTVI also negatively correlated with LVEDP (r = -0.740, P < 0.01 and r = -0.567, P < 0.01) and the correlation coefficient between VVI and LVEDP was significantly higher than that between QTVI and LVEDP (Z = 2.595, P = 0.009). However, there was no correlation between E/A and LVEDP (r = 0.117, P = 0.415). CONCLUSION: E/Em and Em derived from VVI and QTVI are valuable parameters for evaluating LV diastolic function.

[Effects of polyethylene oxide on blood perfusion in the hind limbs of rats with chronic hindlimb ischemia].

OBJECTIVE: To evaluate the effects of polyethylene oxide (PEO) on blood perfusion in hind limb skeletal muscles in a rat model of chronic hind limb ischemia. METHDOS: Twelve rat models of chronic hind limb ischemia established by unilateral femoral artery ligation were randomized into PEO and control groups (n=6) and treated with intravenous infusion of PEO and saline through the internal jugular vein every other day for 2 weeks. Contrast-enhanced ultrasonography was performed after the treatments to evaluate the blood flow in the skeletal muscles at different time points and blood flow reserve in the ischemic hind limbs on day 28. RESULTS: Starting from 7 days after femoral artery ligation, blood flow in the ischemic hind limb skeletal muscles was significantly higher in PEO group than in the control group (P<0.05). On day 28, blood flow reserve in the ischemic hind limb was significantly higher (P=0.012), and blood volume was significantly increased in PEO group as compared that in the control group (P=0.024). CONCLUSIONS: PEO can increase blood flow, blood flow reserve and vascular volume in the hind limb skeletal muscles in rats with chronic hind limb ischemia, suggesting that PEO can promote angiogenesis and arterial formation by increasing blood flow shear stress to improve blood supply of ischemic hind limbs.

[Targeted adhesion of platelet receptor-specific microbubble agent to thrombus in vitro].

OBJECTIVE: To examine the thrombus-targeting effect of platelet receptor-specific lipid microbubbles. METHODS: The targeted microbubbles were prepared by coupling Arg-Gly-Asp-Ser (RGDS) with the lipid microbubbles, which were added to the microthrombus generated by platelet aggregation. The effects of the targeted microbubbles on the ultrasonic signal was observed in an artificial thrombus model. RESULTS: The targeted microbubbles were adhesive to the microthrombus, while the non-targeted microbubbles did not possess this property. The ultrasonic signal of the thrombus border was enhanced significantly after the addition of the targeted microbubbles. CONCLUSIONS: Platelet receptor-specific microbubbles possess significant adhesive property to the thrombus and can improve signal-to-noise ratio of the thrombus, suggesting the potential value of the targeted microbubbles for clinical application in the diagnosis and treatment of thrombus.

[Quantification of renal medullary perfusion with contrast-enhanced ultrasound: an experimental study].

OBJECTIVE: To quantitatively evaluate the effects of dopamine (DA) and noradrenaline (NE) on renal medullary perfusion and the differences in perfusion in the outer and inner medulla using contrast-enhanced ultrasound. METHODS AND RESULTS: Contrast-enhanced ultrasound was performed in 10 dogs with simultaneous renal artery flow (RAF) measurement at the baseline level and during application of 3 different doses of DA and NE. During treatment with the 3 doses of DA, the changes of ultrasound-derived parameters (A, beta and A*beta) in the medulla were similar to the changes in the cortex. As compared with the baseline level, the ratios between the cortex and medulla exhibited no significant difference in A, beta and A*beta during DA treatment (P>0.05). No significant difference in ultrasound-derived medullar parameters was noted in dogs with NE treatment from the baseline level (P>0.05). However, a progressive decrease in the ratios of A, beta and A*beta between the cortex and medulla was noted during NE treatment in comparison with the baseline level (P<0.05). The velocity (beta) and perfusion (A*beta) of blood flow in the medulla decreased progressively from the outer medulla to the inner medulla at baseline (P<0.05), while the blood volume (A) remained unchanged (P<0.05). CONCLUSIONS: The changes of blood flow in both the cortex and medulla are identical during DA treatment but different in the presence of NE. The progressive decrease in perfusion from the outer medulla to the inner medulla is attributed to the decrease in the velocity of blood flow.

[An experimental study on renal microvascular perfusion in dogs with acute cardiac insufficiency].

OBJECTIVE: To investigate the changes and the effects of captopril on the renal blood flow and microvascular perfusion in dogs with acute cardiac insufficiency. METHODS: Acute cardial insufficiency was induced by combining occlusion of the left anterior descending artery with right ventricular pacing in 12 mongrel dogs. The ascending aorta and left kidney were dissected and ultrasonic flow probes were placed on ascending aorta and renal artery to monitor cardiac output (CO) and renal blood flow (RBF). Contrast-enhanced ultrasound of the kidney was performed as CO was reduced to 25% (LCO25%) and 50% (LCO50%) from the basic measurement and microvascular flow velocity (beta), microvascular volume (A) and microvascular blood flow (renal cortex) were observed. After CO reduced to 50%, captopril 1 mg/kg and 2 mg/kg were injected successively and contrast-enhanced ultrasound of the kidney were performed again before and after injection. RESULTS: At baseline, CO, RBF, CXbeta (beta of renal cortex), A and A x beta were (1.46 +/- 0.16) ml/min, (107.5 +/- 35.7) ml/min, 1.39 +/- 0.14, 120.3 +/- 14.8 and 167.4 +/- 25.0, respectively. After the LCO25% was reached, RAF, CXbeta, A and A x beta decreased to (72.50 +/- 32.4) ml/min, 0.87 +/- 0.082, 117.6 +/- 13.1, and 102.6 +/- 15.5, respectively. The corresponding values after the LCO50% was reached were (44.1 +/- 17.2) ml/min, 0.61 +/- 0.039, 106.9 +/- 12.0, and 64.7 +/- 8.83, respectively. It is suggested that the volume of the renal microvasculature remained stable until the LCO50% was reached. When captopril 1 mg/kg and 2 mg/kg were injected successively at LCO50%, MAP decreased from (85.4 +/- 7.8) mm Hg to (78.7 +/- 7.3) mm Hg and to (69.1 +/- 6.3) mm Hg (P < 0.05), respectively, while CO increased from 0.73 +/- 0.084 to 0.83 +/- 0.065 and to 0.9 +/- 0.054 (P < 0.05), respectively. RBF increased from (44.1 +/- 17.2) ml/min to 60.3 +/- 17.8 and to 79.4 +/- 17.8 (P < 0.05), respectively. After captopril 1 mg/kg and 2 mg/kg were injected, the increased flow ratios with CO were 0.15 +/- 0.084 and 0.31 +/- 0.011, respectively, and with RBF were 0.29 +/- 089 and 0.522 +/- 0.040, respectively. The increased renal blood flow ratio was higher than that of CO after captopril was used. The corresponding increases were from 0.61 +/- 0.039 to 0.75 +/- 0.020 and to 0.86 +/- 0.027 for CX beta, from 106.9 +/- 11.9 to 115.4 +/- 11.1 and to 116.6 +/- 8.9 for A, from 64.7 +/- 8.83 to 87.0 +/- 8.6 and to 100.6 +/- 8.9 for A x beta, respectively. CONCLUSION: The renal microvasculature plays a role by keeping its volume stable in the protection against renal ischemia when acute cardiac output decreases slightly. The role of captopril to improve renal microvascular perfusion is independent of increased total cardiac output or increased systemic blood pressure.

[Ultrasound microbubbles promote thrombolysis of rabbit femoral artery thrombus].

OBJECTIVE: To evaluate the efficacy of intravenous ultrasound microbubbles for thrombolysis of arterial thrombus without using thrombolytic drugs. METHODS: Twelve rabbit models of acute bilateral femoral artery thrombosis were established and 6 of them received transcutaneous ultrasound and intravenous albumin microbubble treatment for thrombosis on one side while only microbubble treatment for the other side. The other 6 rabbits received ultrasound treatment on one side but no treatment on the other to serve as the control group. RESULTS: None of the 6 arteries treated with microbubbles alone and only 2 arteries treated with ultrasound alone in the 6 control rabbits were recanalized. All the 6 femoral arteries treated with microbubbles together with ultrasound were recanalized (P=0.014), with significantly shorter patent time and smaller residual thrombus cross-sectional area than those of the arteries with only ultrasound treatment (P=0.004 and P=0.003, respectively). CONCLUSION: Treatment with intravenous microbubbles assisted by transcutaneous ultrasound effectively promotes arterial thrombolysis in vivo, and this technique can be of significance in clinical treatment of acute thrombotic occlusions.

[Discrepancy between the blood flow in hyperperfused epicardial coronary vessels and myocardial microcirculation following reperfusion: a study in canines].

OBJECTIVE: To investigate the hemodynamic changes in the epicardial coronary blood flow (ECBF) and myocardial microcirculation (MMC) during reactive hyperemia (RH) in response to reperfusion following 2-min ischemia in the left anterior descending coronary artery of canines. METHODS: Twelve adult mongrel dogs were used, whose left anterior descending coronary artery was separated and ligated for 2 min twice below the first branch. The heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, ECBF and MMC were measured respectively before and after the ligation and at 5, 10, 15, 30, 45, 60, 90 and 120 s after reperfusion. ECBF was determined with Doppler coronary flowmeter and MMC derived from the ultrasonic intensity measured by myocardial contrast echocardiography. RESULTS: During the course of RH, ECBF and MMC both evinced responses to hyperperfusion but in manners different in view of their hemodynamic changes, demonstrating the mismatch between them in this condition. ECBF exhibited a much higher peak flow increase than MMC. CONCLUSIONS: RH occurs in response to reperfusion after short-term (2 min) myocardial ischemia, when the discrepancy arises between ECBF and MMC. The primary mechanism might involve the recruitment of the capillaries and the opening of the shunt through the capillaries, and as a consequence, the myocardial perfusion is increased at the cost of decreased reserve of the coronary microcirculation.

[Cloning of expression vector for VEGF121 and VEGF165 genes encoding human vascular endothelial growth factor].

OBJECTIVE: To clone and construct the expression vector for human vascular endothelial growth factor (VEGF) genes. METHODS: Total RNAs were extracted from human lung tissue of a 4-month-old fetus and subjected to reverse transcriptase-polymerase chain reaction (RT-PCR) with the amplified products cloned into pMD18-T vector. Sequence analysis was performed before the amplified products were cloned into the expression plasmid pcDNA3.1-, the recombinant of which was verified by endonuclease digestion. RESULTS: After RT-PCR using a pair of primers (sense -21/7 bp and antisense 554/576 bp), two bands were identified. The band (487 bp) shorter in length was confirmed as VEGF121 (with the full length of VEGF121 being 444 bp) while the longer band (619 bp) was normal VEGF165 (with the full length of VEGF165 being 576 bp). Interestingly, another slightly longer VEGF165 nucleotide sequence was identified by sequencing analysis, which featured an unique 20 bp insertion precisely between exon 3 and exon 4 from the first ATG of human VEGF165 cDNA. The 20 bp insert was identified as the retaining intron 3 terminal nucleotides containing the splicing signal, which caused frame shift mutation in the reading frame and could probably give rise to a short polypeptides consisting of only 97 amino acid residuals due to the early appearance of stop code UAG in the middle of exon 4. CONCLUSION: We have successfully constructed the expression vector for VEGF121 and VEGF165 genes, and a new possible alternative splicing isoform of VEGF is identified in normal fetus whose molecular mechanism and physiological function needs further investigation.

[Conditions of contrast ultrasound that affect the proliferation of rat smooth muscle cells].

OBJECTIVE: To investigate the effect of an echo-contrast agent on the proliferation of rat smooth muscle cells under different ultrasound conditions. METHODS: The vascular smooth muscle cells of rats were cultured with echo-contrast agent in 96-well plates, followed by exposure to ultrasound of different conditions. Trypan blue staining was performed 48 h later, and the proliferation of the cells observed by MTT assay. RESULTS: No cytotoxicity was found by trypan blue staining when the mechanical index of ultrasound was below 0.75. Compared with the control cells, the proliferation of the smooth muscle cells was decreased following the exposure as the mechanical index of ultrasound increased. The most obvious inhibition of cell proliferation was resulted when the microbubble concentration was 20% for a 60-second exposure. CONCLUSIONS: The inhibition of the vascular smooth muscle cell proliferation by echo-contrast agent destruction is correlated with the mechanical index of the ultrasound, concentration of the echo-contrast agent, and exposure time of ultrasound.

Evaluation of myocardial viability with myocardial contrast echocardiography: a preliminary clinical study.

OBJECTIVE: To evaluate the efficacy of myocardial contrast echocardiography (MCE) in the assessment of myocardial viability, with positron emission tomography (PET) as the golden standard. METHODS: Eleven patients with anterior wall Q wave myocardial infarction were enrolled in this study, who received successful percutaneous transluminal coronary angioplasty (PTCA) 3 to 19 months prior to the examinations by PET and MCE that were completed within 2 d. RESULTS: MCE score for the segments of necrotic myocardium, viable myocardium and normal myocardium was mostly 0, 0.5 and 1 respectively, and there was a significant difference between the grades of MCE score in identifying myocardial viability. In terms of diagnosing myocardium survival, MCE result was closely correlated with that of PET (with the correlation index rp of 0.78). CONCLUSION: Myocardial perfusion evaluation can be effectively accomplished by MCE, which might serve as a new approach to assess myocardial viability in clinical practice.

Value of echocardiography for observing left ventricular hypertrophy in the diagnosis of myocardial microvascular damage in hypertensives.

OBJECTIVE: To investigate the value of the echocardiographic observation of the left ventricular hypertrophy (LVH) in diagnosing myocardial microvascular damage in patients with essential hypertension (EH). METHODS: After intravenous injection with Quanfuxian (a contrast agent consisting of albumin and C3F8 prepared by Nanfang Hospital), the values of A (the maximum number of microbubbles accumulating in the local tissues for assessing the density of local microvessels), beta (the filling velocity of contrast agent for evaluating local blood flow velocity) and A x beta (the product of A and beta for estimating local myocardial blood flow) at rest and after dipyridamole injection were measured by intermittent harmonic imaging with myocardial contrast echocardiography (MCE). The ratios of A and beta along with the microvascular coronary flow velocity reserve (CFVR) were also calculated. RESULTS: Compared with the control group, the rest values of A, beta and A.beta in EH patients were higher, especially in those with LVH. After dipyridamole injection, the values of A, beta, A x beta and the ratios of A and beta, along with CFVR as well, were significantly lowered (P <0.01), and the reductions were especially obvious in LVH cases. As the hypertension exacerbated, the values of A and A x beta tended to increase in positive correlation with systolic and diastolic blood pressure (P <0.01), while the ratio of A and CFVR were decreased, the latter was inversely correlated with diastolic blood pressure (r=-0.55, P <0.01). Positive correlations were noted of the values of A and A x beta with the left ventricular mass and left ventricular mass index (P <0.01). CONCLUSION: EH patients, especially those with LVH, are characterized by increased rest myocardial microvascular blood flow, impaired myocardial microvascular flow reserve and endothelium independent vasodilation relaxing ability, and reduced capillary density, and these conditions tend exacerbate as the disease worsens. Microvascular function impairment should be suspected when complication of LVH arises in the EH patients. As a new important noninvasive technique, MCE can be a promising modality for diagnosing microvascular disease in essential hypertension.

[Velocity vector imaging for left ventricular diastolic function assessment and the reference values].

OBJECTIVE: To study value of velocity vector imaging (VVI) in assessment of normal left ventricular diastolic function and the corresponding reference values. METHODS: Ninety-seven healthy subjects were selected by combined clinical, ultrasound, and NT-proBNP examinations. Using a Siemens Acuson Sequoia C512 echocardiograph, VVI was adopted to examine the myocardial early diastolic velocity (E) of the septal, lateral, anterior, inferior, anterior septum, and posterior wall of the left ventricle at the level of mitral annulus. The images were analyzed for VVI and the mean diastolic velocity (E(m)) and hence the E/E(m) ratio was calculated based on the offline workstation interface. RESULTS: The reference range of E/E(m) ratio derived from the data of the 97 healthy subjects was (unilateral boundaries with 95% limit) and (1, 22.935), was (1, 22.300) in male subjects and (1, 24.766) in female subjects. The reference E/E(m) range was (0, 22.413) in male subjects under 50 years of age, (1, 24.766) in female subjects under 50 years, (1, 22.300) in male subjects over 50 years, and (1, 24.766) in female subjects over 50 years. CONCLUSION: VVI is a good method for non-invasive evaluation of the left ventricular diastolic function and provides an accurate and reliable means for clinical assessment of the left ventricular diastolic function.

[Effects of acute cerebral ischemia on cerebral perfusion: quantitative evaluation by contrast-enhanced ultrasound in dogs].

OBJECTIVE: To evaluate the changes of cerebral blood flow (CBF) with real-time contrast-enhanced ultrasound (CEU) in a canine model of acute cerebral ischemia. METHODS: Cerebral perfusion was assessed in 6 dogs subjected to craniotomy with CEU at the time of 0, 30, 60, 90 and 120 min after occlusion of the left common carotid artery (LCCA). The microvascular volume (A) and blood flow velocity (beta) in the brain were measured from the time-versus-acoustic intensity plots, and the value of Axbeta were calculated. 99mTc-ECD brain single photon emission computed tomography (SPECT) was performed on the day before the experiment and at 120 min after LCCA occlusion. The radioactive counts on both sides of the cerebral cortex were calculated. RESULTS: A significant correlation was found between Axbeta from CEU and volume of the blood flow of the CCA from Doppler flowmetry. A, beta and Axbeta values varied significantly between the different time points (P>0.001). The ipsilateral hemisphere showed a low-perfusion state while the contralateral hemisphere showed a high-perfusion state immediately after the occlusion. CONCLUSIONS: The changes of beta is the main regulation mechanism during acute cerebral ischemia in dogs.

[Effects of polyethylene oxide at different concentrations on abdominal aortic blood flow and vascular resistance in rats].

OBJECTIVE: To observe the effect of polyethylene oxide (PEO) solution at different concentrations on abdominal aortic blood flow and vascular resistance in rats and evaluate the safety and drag-reducing effect of PEO solution. METHODS: Thirty-two rats were anesthetized and randomly divided into 4 groups. An ultrasonic flow probe was deployed on the abdominal aorta (5 mm above the common iliac artery) to measure the blood flow. The carotid artery pressure, iliac artery pressure, iliac vein pressure, central venous pressure (CVP) and ECG were also monitored. Saline or different concentrations of PEO [(1x10(-6)(low), 1x10(-5)(middle) and 5x10(-5)(high) g/ml)] were injected in the 4 groups of rats through the caudal vein at a constant rate of 5 ml/h for 20 min, and the changes of the vascular resistance was observed. RESULTS After injections of 1x10(-6) and 1x10(-5) g/ml PEO, the abdominal aortic flow increased significantly (P<0.05) while the vascular resistance was reduced (P(low)=0.052, P(middle)<0.001) as compared to those in the saline control group. Following the injection with 5x10(-5) g/ml PEO, the abdominal aortic flow increased to a threshold in the initial 4 min, after which it rapidly decreased to approach the baseline levels despite continuous infusion. Blood pressure remained stable after the injections except for 5x10(-5) g/mlPEO injection, which resulted in a reduction of the blood pressure by about 10 mmHg (P=0.014). The heart rate and CVP both underwent no significant changes following the injections. CONCLUSION: The drag-reducing effect of PEO is closely related to its concentration, and compared with 1x10(-6) g/ml, 1x10(-5) g/ml PEO more effectively increases the blood flow and decreases the resistance. The effectiveness and safety of EPO are attenuated at a concentration higher than 5x10(-5) g/ml.

[Impact of ultrasound-mediated microbubbles on myocardial vascular permeability in rats].

OBJECTIVE: To investigate the impact of high-dose microbubbles induced by high mechanical index myocardial contrast echocardiography (MCE) on vascular permeability and its recovery time in rats. METHODS: Thirty male Wistar rats were randomized into 4 MCE groups (groups A-D) and a control group. In the MCE groups, Evans blue was injected at 10 s before MCE (A), immediately after the end of MCE (B), and at 5 min (C) and 20 min after the end of MCE (D). In the control group, the microbubbles and Evans blue were injected at the end of a 5-min ultrasound exposure. All the rats were sacrificed 5 min after Evans blue injection, and the content of Evans blue in the myocardium and the percentage of Evans blue leakage area were determined. RESULTS: The percentage of Evans blue leakage area in groups A, B and C were significantly higher than that in the control group (P<0.05), while the percentage was similar between group D and the control group (P>0.05). Evans blue contents in groups A and B were significantly higher than that in the control group (P<0.05), but groups C and D showed comparable contents with the control group E (P>0.05). No significant changes of the heart rates and premature beat number were observed during and after MCE in these groups (P>0.05). CONCLUSION: High mechanical index MCE and a high contrast dose may induce increased microvascular leakage in rats, and the vascular permeability can recover in 20 min after MCE.

[Effect of polyethylene oxide on red blood cell velocity in rat cremaster microcirculation].

OBJECTIVE: To investigate the drag-reducing effect of polyethylene oxide (PEO) on the velocity of red blood cells in rat cremaster microcirculation. METHODS: Blood samples were collected from 6 Wistar male rats (100-110 g) via the post-orbital venous plexus. The red blood cells were separated by centrifugation and labeled by fluorescinisothiocyate (FITC). After successful establishment of cremaster model, the labeled red blood cells were injected into the jugular vein, and the microcirculation was observed and recorded under fluorescence microscope. The hemodynamic parameters and microcirculation video was recorded every 4 min since 4 min before PEO or normal saline injection. Both PEO (10 ppm) and normal saline was injected into the same rat in random sequence at a constant rate of 3.5 ml/h for 20 min followed by observation for another 20 min. The velocity of the labeled-red blood cells was determined by IPP 6.0 software. RESULTS: Compared with normal saline, PEO significantly increased the velocity of the red blood cells in the rat cremaster microcirculation (498.7-/+182.89 microm/s vs 773.54-/+308.27 microm/s, P=0.012). No significant changes in the heart rate and arterial blood pressure were observed during the experiment (P=0.836, P=0.420). CONCLUSION: PEO at an extremely low concentration can significantly increase the velocity of the red blood cells in rat cremaster microcirculation and produces no significant impact on heart rate and arterial blood pressure.

[Targeted delivery of bone marrow mesenchymal stem cells by ultrasound-mediated microbubble destruction].

OBJECTIVE: To investigate the feasibility of bone marrow mesenchymal stem cell (MSC) transplantation with ultrasound-targeted microbubble destruction. METHODS: Twenty-one Wistar rats were divided into MSCs-iv group (MSCs-iv), ultrasound+MSCs-iv group (US+MSCs-iv), ultrasound+microbubble+MSCs-iv group (US+MB+MSCs-iv) with intravenous MSC transfer, ultrasound and microbubble treatment as indicated. The skeletal muscles were obtained from the rats for microscopic examination with HE staining. The hindlimb gracilis and semimembranosus muscles were sampled 7 days after MSC transplantation, and the transplanted MSCs were detected by immunohistochemistry. The vital organs were collected from rats in US+MB+MSCs-iv group for immunohistochemistry. RESULTS: In US+MB+MSCs-iv group, HE staining demonstrated the presence of red blood cell leakage into the tissue space in the gracilis and semimembranosus muscles, and immunohistochemistry identified large numbers of transplanted MSCs in the the gracilis and semimembranosus muscles and the spleen, whereas no labeled cells were detected in the skeletal muscles in other groups. CONCLUSION: Ultrasound-targeted microbubble destruction provides a useful means for enhancing the efficiency of stem cell transplantation.

[Evaluation of left ventricular diastolic function in canine acute myocardial ischemia using velocity vector imaging and quantitative tissue velocity imaging].

OBJECTIVE: To assess the value of velocity vector imaging (VVI) and quantitative tissue velocity imaging (QTVI) in assessing left ventricular diastolic function of the dogs with acute myocardial ischemia. METHODS: Six healthy mongrel dogs were subjected to ligation of the left circumflex artery or left anterior descending artery to induce coronary artery stenosis of varying degrees. The mean peak diastolic velocity (Em) of the ventricular walls around the mitral annulus was recorded with VVI or QTVI in the coronary blood flow. The left ventricular end diastolic pressure (LVEDP) was measured with pigtail catheter in the left ventricle. RESULTS: As the coronary blood flow decreased, LVEDP was gradually increased, and Em measured by VVI or QTVI were also gradually decreased. A good linear correlation was shown between Em measured by VVI or QTVI and LVEDP (r=-0.834, P<0.001, and r=-0.68, P<0.001, respectively). A significant difference was observed in the correlation coefficient between VVI and QTVI (Z=2.625, P=0.0087). CONCLUSION: VVI and QTVI both provide good noninvasive means for measuring left ventricular diastolic function. VVI, a new echocardiographic modality without angular dependence, is better than QTVI in evaluating left ventricular diastolic function.

[Assessment of direct effects of dobutamine on coronary microcirculation with myocardial contrast echocardiography: comparison with adenosine].

OBJECTIVE: To evaluate the direct effects of dobutamine as compared to adenosine on the coronary microcirculation in both normal and stenotic segments using myocardial contrast echocardiography (MCE). METHODS: Left anterior descending (LAD) coronary artery stenosis, which was not flow limiting at rest, was established in 9 dogs. At the baseline and during intracoronary infusion of dobutamine (2 mg.kg(-1).min(-1)) and adenosine (5 mg.kg(-1).min(-1)), the radiolabeled microsphere (RM)-derived myocardial blood flow (MBF) were determined, and the double product (DP) and myocardial vascular resistance (MVR) were calculated. MCE was performed to determine the myocardial blood volume (MBV, represented by A) and microbubble velocity (beta). RESULTS: As compared to the baseline level, the MBF increased and MVR decreased significantly in both the normal and abnormal beds during infusion of both drugs (P<0.05). In the normal bed, adenosine had no effect on MBV, the decrease in MVR was the result of decreased arteriolar (plus venular) resistance, and the increase in MBF was predominately due to the increase in b (deltabeta/ deltaA=13.6). Dobutamine caused a 28% increase in MBV, responsible for 32% of the decrease in the total MVR, but the increase in MBF arose mainly from the increase in b (deltabeta/deltaA=5.9). In the abnormal bed, both the drugs caused a similar increase in MBF entirely by increasing b, and 14% and 15% of the increases in capillary resistance were associated with the capillary derecruitment during administration of dobutamine and adenosine, respectively. CONCLUSION: The direct effects of intracoronary dobutamine infusion on the coronary microcirculation are similar to that of adenosine, and the increase in MBF occurs mostly as the result of increased myocardial blood velocity.

[Nitroglycerine promotes myocardial oxygen metabolism and regional cardiac function in vivo].

OBJECTIVE: To investigate the effects of nitroglycerine (NTG) on myocardial oxygen metabolism and regional cardiac function in canine hearts with a stable systemic hemodynamics in situ. METHODS: Eight anesthetized open-chest dogs with flow-limited left anterior descending branch of the coronary artery or left circumflex artery (LCx) stenosis were studied. The percentage of ventricular wall thickening (%WT) was measured with quantitative two-dimensional echocardiography (2DE), myocardial blood flow (MBF) with radiolabeled microspheres and tissue oxygen pressure (tPO(2).) with oxygen-dependent quenching of phosphorescence. 2DE was performed and radiolabeled microspheres and Pd-porphyrin injected in the dogs at rest during intracoronary infusion of 0.3-0.6 mg x kg(-1) x min(-1) of NTG. Myocardial oxygen consumption (MVO(2), ml x min(-1) x 100 g(-1)) was calculated as the multiplication product between the arterio-venous oxygen content difference and MBF, and myocardial O(2) delivery as the product between arterial oxygen content and MBF. RESULTS: As compared with the baseline, NTG increased %WT and MBF significantly in both normal and ischemic beds (P<0.05). There was a significant increase in MVO(2) during NTG infusion in the ischemic bed (P<0.05) in comparison with that measured at rest. NTG, however, significantly increased the ability of myocardial O(2) delivery in both normal and ischemic beds (P<0.05), therefore tPO(2) was still higher in the ischemic bed during NTG infusion than that at rest (P<0.05). The percentage increment in tPO(2) was significantly greater in the ischemic bed than percentage MBF increment. CONCLUSIONS: NTG enhances myocardial oxygen concentration in normal and ischemic myocardium and may increase oxygen release to the ischemic myocardium in vivo. NTG may have a positive inotropic effect on regional cardiac function. In addition to direct effect on vascular tone, NTG plays important roles in the cardiovascular system by modulating myocardial oxygen metabolism and contractile function.