DETECTION OF REGIONAL PERFUSION ABNORMALITIES DURING ADENOSINE STRESSECHOCARDIOGRAPHY WITH INTRAVENOUS PERFLUOROCARBON-EXPOSED SONICATED DEXTROSE ALBUMIN

Although perfluorocarbon-exposed sonicated dextrose albumin (PESDA) mi crobubbles produce myocardial contrast after intravenous injection, it is unknown whether their use can accurately identify myocardial blood -flow abnormalities during stress echocardiography. Accordingly, we co mpared the background-subtracted peak myocardial videointensity (PMVI) after intravenous injections of PESDA before and during adenosine str ess (100 to 140 units/kg/min) in 10 open-chest dogs with angiographica lly significant left circumflex artery disease. The ratios of PMVI in the ischemic region compared with the adjacent normal left anterior de scending perfusion bed were measured, as were wall-thickening and coro nary-flow ratios. In the dogs with a >50% diameter stenosis, there was a decrease in PMVI ratio during adenosine stress by >0.20 in 9, where as wall-thickening ratios decreased in only 5. PMVI in the ischemic zo ne increased by <1.5 units during adenosine infusion in 8 of 10 dogs, whereas it increased by >1.5 units in 8 of 10 adjacent normal zones. W e conclude that regional myocardial-perfusion abnormalities can be det ected with intravenous PESDA during adenosine stress echocardiography.