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Assessment of Adenosine-induced Coronary Steal in the Setting of Coronary Occlusion Based on the Extent of Opacification Defects by Myocardial Contrast Echocardiography

Barry Peters, MD

Stephane Lafitte, MD

G. Monet Strachan, RDCS,

Koji Ohmori, MD

Katsufumi Mizushige, MD

Masakazu Kohno, MD

The authors examined the ability of real-time myocardial contrast echocardiography (MCE) to assess adenosine-induced coronary steal in the setting of coronary artery occlusion. The left anterior descending (LAD) coronary artery was occluded in 8 open-chest dogs. Real-time MCE was performed during LAD occlusion, and the extent of opacification defects from MCE was measured without and with adenosine infusion. Microsphere-derived myocardial blood flow (MBF) was measured in the LAD and left circumflex (LCx) coronary artery beds, and the LAD/LCx ratio of MBF was calculated. The LAD/LCx ratio of MBF decreased in response to adenosine administration (without adenosine: 0.66, with adenosine: 0.43, p < 0.01). The extent of opacification defects from MCE increased in response to adenosine administration (without adenosine: 18%, with adenosine: 22%, p < 0.01). Thus, real-time MCE allows for the detection of adenosine-induced coronary steal as changes in the extent of opacification defects in the setting of occlusion of 1 coronary artery accompanying another normally patent coronary artery.

Angiology, Vol. 54, No. 4, 443-448 (2003)
DOI: 10.1177/000331970305400408


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