Abstract Objective: To explore a non-invasive method for the determination of coronary flow reserve(CFR) by stress myocardial contrast echocardiography(MCE) and its application in evaluating coronary microcirculation dysfunction(CMD). Methods: A total of 161 patients with non-obstructive coronary artery disease hospitalized due to chest pain were enrolled. All patients underwent adenosine triphosphate(ATP) stress MCE, and QLab was used to quantitatively analyze the myocardial plateau signal intensity(A) and signal intensity exchange rate(β) at rest and post-stress. Myocardial blood flow(MBF) is expressed as A×β, and CFR equals stress MBF divided by rest MBF. CMD is defined as CFR<2.0. Multivariate Logistic regression analysis was used to screen the influencing factors of CMD. Results: The incidence of CMD in patients with non-obstructive chest pain was 51.6%. Compared with the normal group, the incidence of diabetes, hyperlipidemia and the proportion of E/e’>15 in CMD was significantly increased. Multivariate Logistic regression analysis showed that E/e’>15 was an independent risk factor for CMD. Conclusion: MCE is an effective noninvasive method for the determination of CFR. The incidence of CMD in patients with non-obstructive chest pain was 51.6%. It was also associated with increased left ventricular end-diastolic pressure.
LIU Jia-nan,SUN Yu-jia,AN Huan-huan, et al. Clinical application of stress myocardial contrast echocardiography in the determination of coronary flow reserve[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(3): 180-183.
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