Feasibility Studies Of Videodensitometric Scale To Assess Myocardial Microperfusion

Objective To discuss the feasibility of videodensitometric scale (VDS) assessing myocardial microperfusion during coronary angiography compared with corrected TIMI frame counted (CTFC) , single photon emission computerized tomography (SPECT) and myocardial contrast echocardiography(MCE).MethodsAnimal experiment:To embolize small coronary artery of dogs by ejecting polystyrene microbubble (dm= 100μm). Among the eleven dogs, five were embolized by LAD and six were embolized by LCX. Coronary angiography was performed before and after the embolization. MCE and SPECT were performed in 12 hours after embolization. VDS was calculated according to coronary angiography. Ventricular wall motion score (VWM scale), MCE scale and SPECT scales were calculated.Clinical study:VDS and CTFC were analyzed on 58 cases with normal coronary artery and 120 acute myocardial infarction (AMI) patients. TIMI grade, left ventricular ejection fraction, symptom-catheter time and main adverse cardiac events(MACE) were noticed during hospitalization.Results1. Among the eleven experimental dogs, VDS were higher before embolization than after that (24.4±4.9 vs 15.2±3.8,P<0.05);VWM score and MCE score were 8.5±2.5, 7.6±2.4;SPECT score were 17.8±6.3.2. VDS was negatively dependent with MCES ( γ = - 0.78,P<0.05) and was negatively dependent with SPECTS ( γ = - 0.85, P<0.05).3. VDS and CTFC in normal coronary artery are mormal distribution.VDS was 22.5±5.8 and CTFC was 21.1±4.5. VDS was negatively dependent with CTFC (y= -0.86, P<0.05). There was no statistic difference between the different coronary artery about VDS and CTFC. The 95% confidence interval of VDS in normal artery was ( 20.2, 24.7 ) .4. VDS after artery opening were higher than no-opening (20.8±7.6 vs 10.2±3.8, P<0.05);CTFC before PCI were lower than after that (30.3±8.6 vs 22.4±5.6, P<0.05). VDS after opening artery was lower than normal coronary artery (P<0.05 ) . But CTFC after opening artery was no statistic difference with normal artery ( P>0.05 ) .5. LVEF after PCI was dependent with VDS and the correlation coefficient (y) was 0.65 (P>0.05) .6. Logistic regression analysis indicated VDS was an independent correlation factor of MACE during hospitalization. Chi square test showed MACE in cases of VDS < 20 was higher than in cases of VDS>20 and in cases of CTFC < 30.Conclusion:1. VDS as a newly quantitive index to assess myocardial microperfusion, which keeps a closely correction with MCE and SPECT. It can be used to assess myocardial microcirculation in clinical.2. VDS is negatively dependent with CTFC. And it was more sensitive than CTFC on assessing myocardial microperfusion of AMI cases.3. VDS is an independent predicted factor of MACE during hospitalization.4. Myocardial microperefusion was abnormal though infarction-related artery was opening.