Utility of myocardial contrast echocardiography for evaluating microvascular dysfunction in patients with ischemia and non-obstructive coronary arteries

Introduction Coronary artery microcirculation dysfunction (CMCD) is due to the abnormal structure or function of the coronary microcirculation, which leads to lower coronary artery blood flow and myocardial perfusion and then to a series of cardiovascular events, such as myocardial ischemia and even heart failure. Purpose The aim of this study was to evaluate the value of myocardial contrast echocardiography (MCE) in detecting coronary microcirculation function dysfunction in ischemia with non-obstructive coronary artery(INOCA) disease. Methods Twenty-one patients with a clinical diagnosis of INOCA were admitted to our medical university hospital because of chest pain. All participants underwent MCE and [ 18 F]fluorodeoxyglucose(FDG) positron emission tomography/computed tomography myocardial metabolic imaging. With the results of FDG PET taken as the gold standard, all myocardial segments were divided into a normal control group and a coronary artery microcirculation dysfunction (CMCD) group. We used MCE to measure myocardial perfusion parameters, including the ascending slope (β), time to peak (TTP), A and A × β. The receiver operating characteristic(ROC) curves of β, TTP, A and A × β were calculated to evaluate the diagnostic value of MCE for CMCD. Results A total of 122 and 218 segments were investigated in the CMCD and control groups, respectively. On the basis of the statistical analysis of the MCE parameters of the two groups, the myocardial perfusion parameters β,A and A × β of all segments in the CMCD group decreased, and the TTP in the basal segment of the CMCD group was longer than that of the normal control group (all p values <0.05). On the basis of analysis of the ROC curve, β had the highest diagnostic efficiency in the middle segment. Conclusion This study found that MCE is valuable in the diagnosis of non-obstructive coronary artery complicated by CMCD.myocardial bull’s—eye map box diagram