TY - JOUR
T1 - Assessment of Coronary Microcirculation with High Frame-Rate Contrast-Enhanced Echocardiography
AU - Wahyulaksana, Geraldi
AU - Wei, Luxi
AU - Voorneveld, Jason
AU - te Lintel Hekkert, Maaike
AU - Bowen, Daniel J.
AU - Strachinaru, Mihai
AU - Duncker, Dirk J.
AU - van der Steen, Antonius F.W.
AU - Vos, Hendrik J.
PY - 2025
Y1 - 2025
N2 - Objective: Assessing myocardial perfusion in acute myocardial infarction is important for guiding clinicians in choosing appropriate treatment strategies. Echocardiography can be used due to its direct feedback and bedside nature, but it currently faces image quality issues and an inability to differentiate coronary macro- from micro-circulation. We previously developed an imaging scheme using high frame-rate contrast-enhanced ultrasound (HFR CEUS) with higher order singular value decomposition (HOSVD) that provides dynamic perfusion and vascular flow visualization. In this study, we aim to show the ability of this technique to image perfusion deficits and investigate the potential occurrence of false-positive contrast detection. Methods: We used a porcine model comprising occlusion and release of the left anterior descending coronary artery. During slow contrast agent infusion, the afore-mentioned imaging scheme was used to capture and process the data offline using HOSVD. Results: Fast and slow coronary flow was successfully differentiated, presumably representing the different compartments of the micro-circulation. Low perfusion was seen in the area that was affected, as expected by vascular occlusion. Furthermore, we also imaged coronary flow dynamics before, during and after release of the occlusion, the latter showing hyperemia as expected. A contrast agent destruction test showed that the processed images contained actual contrast signal in the cardiac phases with minimal motion. With larger tissue motion, tissue signal leaked into the contrast-enhanced images. Conclusion: Our results demonstrate the feasibility of HFR CEUS with HOSVD as a viable option for assessing myocardial perfusion. Flow dynamics were resolved, which potentially helped to directly evaluate coronary flow deficits.
AB - Objective: Assessing myocardial perfusion in acute myocardial infarction is important for guiding clinicians in choosing appropriate treatment strategies. Echocardiography can be used due to its direct feedback and bedside nature, but it currently faces image quality issues and an inability to differentiate coronary macro- from micro-circulation. We previously developed an imaging scheme using high frame-rate contrast-enhanced ultrasound (HFR CEUS) with higher order singular value decomposition (HOSVD) that provides dynamic perfusion and vascular flow visualization. In this study, we aim to show the ability of this technique to image perfusion deficits and investigate the potential occurrence of false-positive contrast detection. Methods: We used a porcine model comprising occlusion and release of the left anterior descending coronary artery. During slow contrast agent infusion, the afore-mentioned imaging scheme was used to capture and process the data offline using HOSVD. Results: Fast and slow coronary flow was successfully differentiated, presumably representing the different compartments of the micro-circulation. Low perfusion was seen in the area that was affected, as expected by vascular occlusion. Furthermore, we also imaged coronary flow dynamics before, during and after release of the occlusion, the latter showing hyperemia as expected. A contrast agent destruction test showed that the processed images contained actual contrast signal in the cardiac phases with minimal motion. With larger tissue motion, tissue signal leaked into the contrast-enhanced images. Conclusion: Our results demonstrate the feasibility of HFR CEUS with HOSVD as a viable option for assessing myocardial perfusion. Flow dynamics were resolved, which potentially helped to directly evaluate coronary flow deficits.
KW - Blood perfusion
KW - Contrast-enhanced
KW - Coronary vasculature
KW - Echocardiography
KW - Echography
KW - High frame rate
KW - Higher order singular value decomposition
KW - In vivo
UR - http://www.scopus.com/inward/record.url?scp=85213977004&partnerID=8YFLogxK
U2 - 10.1016/j.ultrasmedbio.2024.12.002
DO - 10.1016/j.ultrasmedbio.2024.12.002
M3 - Article
AN - SCOPUS:85213977004
SN - 0301-5629
VL - 51
SP - 585
EP - 591
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
IS - 3
ER -