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Intravascular injection of hydrogen peroxide (HP) produces oxygen microbubbles suitable for echocardiographic contrast enhancement.This study evaluates HP contrast-enhanced two- dimensional echocardiography (2DE) during acute coronary occlusion in a canine model by compari- son with perfusion indicated by antemortem monastral blue (MB) staining, postmortem triphenyltetra- zolium chloride (TTC) infarct sizing, and abnormal wall motion (AWM).Injections of a fresh mixture of 1 to 2 ml 0.3% HP and 1 ml blood were made in 10 closed-chest dogs 6 hr after coronary ligation and short-axis 2DE images were made at four anatomic levels.Optimal preinjection 2DE settings were determined by interaction with an on-line, color-coded, videodensitometer system.The circumferential extent of 2DE contrast defect (ECD) was strongly predictive of the pathologic extent of malperfusion (MB = 0.94 ECD + 4.7%, SEE = 7.7%, r = .93)and of infarction (TTC-= 0.84 ECD + 5%, SEE = 9.4%, r = .89).Moreover, ECD was superior to wall motion abnormality in predicting the extent of both malperfusion and infarction (MB = 0.85 AWM + 0.5%, SEE = 13.1%,r = .78;TTC = 0.77 AWM -0.2%, SEE = 13.5%,r = .75).No adverse hemodynamic effects were seen after HP injection.This study validates the use of HP contrast-enhanced 2DE as a readily repeatable, accurate, in vivo real-time method of quantifying the extent of abnormal regional myocardial perfusion during acute myocardial infarction.Available data indicate that further study is warranted to determine if myocardial contrast adequate to define regional perfusion can be obtained safely by this method in man.Circulation 68, No. 3 6034611, 1983.
Kemper et al. (Thu,) studied this question.