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Coronary vasodilation by noninvasive transcutaneous ultrasound

An in vivo canine study

Takashi Miyamoto, MD^*, Yoram Neuman, MD^*, Huai Luo, MD^*, Doo-Soo Jeon, MD^*, Sergio Kobal, MD^*, Fumiaki Ikeno, MD^*, Michael Horzewski, BS^*, Yasuhiro Honda, MD^*, James M. Mirocha, MS^*, Takahiro Iwami, MD^*, Debra Echt, MD, FACC^*, Michael C. Fishbein, MD, FACC and Robert J. Siegel, MD, FACC^*,*

^* Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center Los Angeles, California USA;
Department of Pathology, UCLA School of Medicine, Los Angeles, California, USA

View larger version (27K): [in a new window]   Figure 1 The protocol and timing of coronary angiography, intravascular coronary ultrasound (IVUS), ultrasound (USD) exposure as well as nitroglycerin (NTG) administration. OB = observation.

View larger version (17K): [in a new window]   Figure 2 Canine coronary artery segments. The canine left coronary angiogram was divided into six segments: three left anterior descending coronary artery (LAD) and three left circumflex coronary artery (LCx) segments. These segments were measured by quantitative coronary angiography. The intravascular coronary ultrasound (IVUS) was recorded as shown in the mid-LAD.

View larger version (47K): [in a new window]   figure 3 The intravascular coronary ultrasound (ivus) mid-left anterior descending coronary artery (lad) area before and after ultrasound. on the vertical axis is the mid-lad ivus area; on the horizontal axis is the time (s/min) of ultrasound exposure. vasodilation increased incrementally with the duration of ultrasound. (inset upper left) baseline ivus image; (inset bottom right) ivus image of vasodilation seen after 5 min of ultrasound exposure. the ivus mid-lad areas in mm2 ± standard deviation (sd) are shown below each of the six time intervals at which the areas were measured.

View larger version (34K): [in a new window]   Figure 4 Quantitative coronary angiography (QCA) measurements. The mean percent change of left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCx) diameter at baseline and after ultrasound (USD) exposure are shown. The vertical axis indicates the mean diameter of the coronary artery by QCA analysis; horizontal axis shows the baseline and the eight subsequent times of measurement during and after USD exposure. Percent change in angiographic diameter is plotted, and the average diameter in mm with standard deviation (SD) is shown below each of the nine time intervals. 1: Baseline 1 (before USD exposure). 2: After 5 min of USD exposure. 3: Baseline 2 (after 5 min of USD exposure followed by a 60-min observation [OB] period). 4: After 30 min of USD exposure. 5: After 60 min of USD exposure. 6: After 90 min of USD exposure. 7: After 30 min of OB. 8: After 60 min of OB. 9: After 90 min of OB. The table below the figure indicates the coronary artery diameter for each of the nine time intervals plotted on the graph.

View larger version (72K): [in a new window]   Figure 5 Coronary angiogram before (a) and after (b) ultrasound (USD). As shown in (b), after USD the coronary artery luminal diameter increases.