Myocardial Contrast Echocardiography (MCE) to Check for Living and Working Heart Muscle
Information source: National Institutes of Health Clinical Center (CC)
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Coronary Disease; Heart Diseases
Intervention: Myocardial contrast echocardiography (Procedure); Dobutamine echocardiography (Procedure)
Phase: Phase 3
Status: Completed
Sponsored by: National Heart, Lung, and Blood Institute (NHLBI)
Summary
Coronary artery disease (CAD) can cause poor blood flow and supply to the heart muscle. It
can result in irreversible damage to the heart muscle and poor function. Before treating
patients with heart disease it is important to know how well the heart is functioning.
Echocardiography is a diagnostic test that can measure heart function. If part of the heart
muscle is not working properly due to previous damage, echocardiography can provide
information about how much improvement can be expected after treatment (surgery or
angioplasty).
The purpose of this study is to compare the accuracy of myocardial contrast echocardiography
(MCE) to dobutamine echocardiography to detect the potential for damaged heart muscle to be
treated and function in patients with heart disease.
Myocardial contrast echocardiography (MCE) does not use radioactivity. It uses sound waves
like standard echocardiography. However, with MCE patients receive an injection of a
"contrast agent" directly into the blood stream through a vein. The contrast agent, called
Optison, is made of tiny microbubbles smaller than red blood cells. The echocardiogram can
detect these microbubbles in the small blood vessels of the heart muscle and allow
researchers to find areas of the heart receiving less blood flow than others.
Echocardiography with Dobutamine does not use radioactivity. It uses sound waves, like
standard echocardiography. During this echocardiogram patients receive doses of a medication
called dobutamine that stimulates the heart to beat stronger and faster. Heart muscle that
does not beat stronger after dobutamine is probably dead, usually as a result of a previous
heart attack.
Clinical Details
Official title: Assessment of Myocardial Viability Utilizing Myocardial Contrast Echocardiography
Study design: Treatment, Efficacy Study
Detailed description:
Dobutamine echocardiography has become a valuable technique for the evaluation of myocardial
viability in patients with coronary artery disease (CAD) and dysfunctional myocardium because
it can accurately predict which myocardial segments will show contractile recovery after
successful revascularization. Myocardial contrast echocardiography (MCE) offers the
potential to evaluate tissue perfusion at the level where oxygen transfer to the myocytes
occurs. MCE, therefore, can provide information regarding the functional status of the
myocardial microvasculature which has a close relationship with myocellular integrity. The
purpose of this study is to evaluate the accuracy of MCE compared to dobutamine
echocardiography to detect myocardial viability in patients with CAD and resting wall motion
abnormalities.
Eligibility
Minimum age: N/A.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Patients undergoing evaluation for CAD who show at least two myocardial segments with wall
motion abnormalities on a baseline echocardiogram will be offered to participate in this
study.
Patients will be adults older than 21 years of age.
No pre-menopausal patients who are lactating, are pregnant or potentially pregnant as
judged by history, physical examination, ultrasound or urine pregnancy test.
No one with unstable angina.
No subjects with recent myocardial infarction (less than 1 month).
No one with frequent ectopy which precludes adequate imaging acquisition.
No subjects with significant hypertension (systolic blood pressure greater than 170 mm
Hg).
No hypotension with basal sitting systolic arterial pressure less than 100 mm HG confirmed
30 minutes later.
No subjects with sinus tachycardia greater than or equal to 100 beats/minute.
No atrial fibrillation.
No inadequate two-dimensional echocardiographic windows.
Locations and Contacts
National Heart, Lung and Blood Institute (NHLBI), Bethesda, Maryland 20892, United States
Additional Information
Related publications: Maisey M. Evaluating the benefits of nuclear cardiology. Q J Nucl Med. 1996 Mar;40(1):47-54. Vanoverschelde JL, Wijns W, Depre C, Essamri B, Heyndrickx GR, Borgers M, Bol A, Melin JA. Mechanisms of chronic regional postischemic dysfunction in humans. New insights from the study of noninfarcted collateral-dependent myocardium. Circulation. 1993 May;87(5):1513-23.
Starting date: May 1999
Ending date: March 2001
Last updated: March 3, 2008
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