Coronary collateral development during chronic ischemia: serial assessment using harmonic myocardial contrast echocardiography
James D. Mills, MD, FACCa,
David Fischer, BSa and
Flordeliza S. Villanueva, MD, FACCa
a Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Figure 1 Outline of six-week experimental protocol. LAD = left anterior descending coronary artery; MCE = myocardial contrast echocardiography; Usph = radiolabeled microspheres.
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Figure 2 Myocardial contrast echocardiography images in one dog demonstrating decrease in risk area size. On day 0 (panel A) there is a large anteroseptal and anterior perfusion defect during transient acute LAD occlusion (region between arrows), which is no longer present during chronic occlusion six weeks later (panel B). The curved double yellow lines schematically indicate the anterior right ventricular-left ventricular junction.
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Figure 3 Serial MCE images obtained in the same dog shown in Figure 2 at day 10 (panel A), day 20 (panel B) and day 30 (panel C). There is a progressive decrease in perfusion defect size (region between arrows). The spatial orientation of these transthoracic images is opposite from the open chest images shown in Figure 2. The curved double yellow lines schematically represent the anterior right ventricular-left ventricular junction.
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Figure 4 Mean MCE perfusion defect size in all dogs, expressed as a percent of the short axis left ventricular slice. MCE = myocardial contrast echocardiography.
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Figure 5 Ratio of videointensity in the LAD relative to LCX bed as a function of time. LAD = left anterior descending coronary artery; LCX = left circumflex coronary artery.
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