| Objective1. To assess the value of ultrasonic tissue characterization with integrated backscatter(IBS) and color kinesis (CK) on viable myocardium of swine with chronic coronary artery stenosis and collateral circulation development.2. To assess the value of ultrasonic tissue characterization with integrated backscatter(TDBS) and color kinesis(CK) on swine with acute myocardial infarction.3. To evaluate clinical predictive value of regional viable myocardium and global left ventricular function before interventional therapy in patients with coronary artery disease (CAD) by the technology of low dose dobutamine stress echocardiography(LDDSE) combined with color kinesis(CK) ,integrated backscatterflBS) and acoustic quantification(AQ).Methods1. Ten swine were performed 'with thoracotomy and pericardiectomy. Ameroid constrictor was then implanted around the left circumflex artery (LCX) proximal to the first marginal branch. Ecocardiography studies [including the images of four standard planes (parathoratic long axis, short axis at papillary muscle level, apical four chambers, apical two chambers) of IBS, CK and two dimension] were performed before ,after 1 day,3 days,l week,2 weeks,3 weeks and 4 weeks, respectively; Coronary angjography was performed to evaluate the degree of stenosis and collaterals ; Left ventricular functions before ,after 1 week,2 weeks,3 weeks and 4 weeks were measured, and pathological studies were performed after 4 weeks.2. HP SONOS 5500 and probe S8 were used. Twelve swine were occluded in the left anterior descending (LAD),then the values of integrated backscatter (IBS) , cyclic variation of IBS(CVIB) , transluminal gradient of CVTB(TGCVIB), delay time of10CVIB(DTCV), the percentage of systolic wall thickening( A T%) and wall motion score index(WMSI) were performed before occlusion, after 1 hour,2 hours and 1~2 weeks by acquiring the images of IBS and CK of parathoratic long axis, short axis at the level of papillary muscle, apical four chambers and two chambers, and then pathological surveys were performed after 4 weeks.3. (1) CK-LDDSE was performed in the thirty nine patients with coronary artery disease before interventional therapy. The stages of stress echocardiography included baseline, incremental doses of dobutamine infusion from 5ug/(kg.min) to 10ug/(kg.min) every three minutes continuously and 5 minutes after stopping infusion. Four standard images of color kinesis (parastemal long axis ,short axis at the papillary muscle level, apical four chambers and apical two chambers) were acquired during dobutamine infusion, in the follow-up of 1 week and 3 months after percutaneous coronary intervention[PCI, including percutaneous transluminal coronary angioplasty(PTCA) and/or stentj, then wall motion score index(WMSI) was calculated. CK-LDDSE was used to judge its accuracy 1 week and 3 months after PCI, with the gold standard of recovery of wall motion after PCI. (2) Integrated backscatter parameters [including calibration of integrated backscatter (IBS%), magnitude of cyclic variation of integrated backscatter(CVIB), calibration of CVIB(CVIB%)^iormalized delay time of cyclic variation(DTCV%)]were measured in patients with CAD during dobutamine infusion before PCI and in the follow-up of 1 week and 3 months after PCI. The standard of dysfunctional viable myocardium was assessed as the increase 20% of CVTB% in the same segment after reperfusion. The sensitivity, specificity and accuracy were evaluated.(3)Acoustic quantification-low dose dobutamine stress echocardiography(AQ-LDDSE) was performed in twenty six patients with CAD. AQ images(apical four chambers) were acquired during baseline and dobutamine infusion before PCI and in the follow-up of 1 week and 3 months after PCI. The parameters of AQ[including end diastolic volume(EDV),end systolic volume(ESV),ejection fiaction(EF),peak filling rate(PFR),peak ejection rate(PER) and time of peak filling rate(TPFR)]were detected, in which EF,PER were systolic i...
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