Echocardiography in Coronary Artery Disease

277 Pages·1988·8.349 MB·English

by  Harvey Feigenbaum (auth.), Cees A. Visser M.D., Gerard Kan M.D., Richard S. Meltzer M.D. (eds.)

ECHOCARDIOGRAPHY IN CORONARY ARTERY DISEASE
DEVELOPMENTS IN CARDIOVASCULAR MEDICINE
Meltzer, R.S., Roelandt, J., ed.: Contrast Echocardiography.1982 ISBN 9-02472-531-3.
Morgariroth, Joel, Moore, E. N., eds.: Sudden cardiac death and congestive heart failure:
Diagnosis and treatment. 1983. ISBN 0-89838-580-6.
Perry, H.M., ed.: Lifelong management of hypertension. ISBN 0-89838-582-2.
Jaffe, E.A., ed.: Biology of endothelial cells. ISBN 0-89838-587-3.
Surawicz, B., Reddy, c.P., Prystowsky, E.N., eds.: Tachycardias. 1984. ISBN 0-89838-588-
1.
Spencer, M.P., ed.: Cardiac doppler diagnosis. ISBN 0-89838-591-1.
Villareal, H. V., Sambhi, M. P., eds.: Topics in pathophysiology of hypertension. ISBN 0-
89838-595-4.
Messerli, F.H., ed.: Cardiovascular disease in the elderly. 1984. ISBN 0-89838-596-2.
Simoons, M.L., Reiber, J.H.C., eds.: Nuclear imaging in clinical cardiology. ISBN 0-89838-
599-7.
Ter Keurs, H.E.D.J., Schipperheym, J.J., eds.: Cardiac left ventricular hypertrophy.
ISBN 0-89838-612-8.
Sperelakis, N., ed.: Physiology and pathophysiology of the heart. ISBN 0-89838-615-2.
Messerli, F.H., ed.: Kidney in essential hypertension. 1983. ISBN 0-89838-616-0.
Sambhi, M.P., ed.: Fundamental fault in hypertension. ISBN 0-89838-638-1.
Marchesi, D., ed.: Ambulatory monitoring: Cardiovascular system and allied applications.
ISBN 0-89838-642-X.
Kupper, W., Macalpin, R.N., Bleifeld, W., eds.: Coronary tone in ischemic heart disease.
ISBN 0-89838-646-2.
Sperelakis, N., Caulfield, J.B., eds.: Calcium antagonists: Mechanisms of action on cardiac
muscle and vascular smooth muscle. ISBN 0-89838-655-1.
Godfraind, T., Herman, A.S., Wellens, D., eds.: Entry blockers in cardiovascular and cerebral
dysfunctions. ISBN 0-89838-658-6.
Morganroth, J., Moore, E. N., eds.: Interventions in the acute phase of myocardial infarction.
ISBN 0-89838-659-4.
Abel, F.L., Newman, W.i-I., eds.:,Functional aspects of the normal, hypertrophied, and failing
heart. ISBN 0-89838-665-9.
Sideman, S., and Beyar, R., eds.: Simulation and imaging of the cardiac system. ISBN 0-
89838-687-X.
van de Wall, E., Lie, K.I., eds.: Recent views on hypertrophic cardiomyopathy. ISBN 0-89838-
694-2.
Beamish, R.E., Singal, P.K., Dhalla, N.S., eds.: Stress and heart disease. ISBN 0-89838-709-4.
Beamish, R.E., Panagia, V., Dhalla, N.S., eds.: Pathogenesis of stress-induced heart disease.
ISBN 0-89838-710-8.
Morganroth, J.,Moore, E.N., eds., Cardiac arrhythmias: New therapeutic drugs and devices.
ISBN 0-89838-716-7.
Mathes, P., ed.: Secondary prevention in coronary artery disease and myocardial infarction.
ISBN 0-89838-736-1.
Stone, H. Lowell, Weglicki, W.B., eds., Pathology of cardiovascular injury.
ISBN 0-89838-743-4.
Meyer, J., Erbel, R., Rupprecht, H.J., eds., Improvement of myocardial perfusion.
ISBN 0-89838-748-5.
Reiber, J.H.C., Serruys, P. W., Slager, c.J.: Quantitative coronary and left ventricular
cineangiography. ISBN 0-89838-760-4.
Fagard, R.H., Bekaert, I.E., eds., Sports cardiology. ISBN 0-89838-782-5.
Reiber, J.H.C., Serruys, P.W., eds., State of the art in quantitative coronary arteriography.
ISBN 0-89838-804-X.
Roelandt, J., ed.: Color doppler flow imaging. ISBN 0-89838-806-6.
van de Wall, E.E., ed.: Noninvasive imaging of cardiac metabolism. ISBN 0-89838-812-0.
Liebman, J., Plonsey, R., Rudy, Y., eds., Pediatric and fundamental electrocardiography.
ISBN 0-89838-815-5.
Higler, H., Hombach, V., eds., Invasive cardiovascular therapy. ISBN 0-89838-818-X.
Serruys, P.W., Meester, G.T., eds., Coronary angioplasty: a controlled model for ischemia.
ISBN 0-89838-819-8.
Tooke, J.E., Smaje, L.H., eds.: Clinical investigation of the microcirculation. ISBN 0-89838-
833-3.
van Dam, Th., van Oosterom, A., eds.: Electrocardiographic body surface mapping. ISBN
0-89838-834-1.
Spencer, M. P., ed.: Ultrasonic diagnosis of cerebrovascular disease. ISBN 0-89838-836-8.
Legato, M.J., ed.: The stressed heart. ISBN 0-89838-849-X.
Safar, M.E., ed.: Arterial and venous systems in essential hypertension, ISBN 0-89838-857-0.
Roelandt, J., ed.: Digital techniques in echocardiography. ISBN 0-89838-861-9.
Morganroth, Joel, Moore, E. Neil, eds.: Congestive Heart Failure. 1987. ISBN 0-89838-955-0.
ECHOCARDIOGRAPHY IN CORONARY ARTERY DISEASE
EDITED BY:
CEES VISSER, M.D.
GERARD KAN, M.D.
RICHARD MELTZER, M.D.
~.
"
KLUWER ACADEMIC PUBLISHERS
BOSTON IDORDRECHT ILANCASTER
© 1988 by Kluwer Academic Publishers
Softcover reprint of the hardcover 1s t edition 1988
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted in any form or by any means, mechanical, photocopying, recording, or
otherwise, without the prior written permission of the publishers,
Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park, Norwell, MA 02061, USA
Distributors
for the United States and Canada: Kluwer Academic Publishers, 101 Philip Drive, Assinippi
Park, Norwell, MA 02061, USA
for the UK and Ireland: Kluwet Academic Publishers, MTP Press Limited, Falcon House,
Queen Square, Lancaster LAI lRN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Centre, P.O. Box 322,
3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging-in-Publication Data
Echocardiography in coronary artery disease.
(Developments in cardiovascular medicine; 80)
Includes index.
1. Coronary heart disease-Diagnosis. 2. Doppler echocardiography.
3. Ultrasonic cardiography.
I. Visser, Cees. II. Kan, Gerard. III. Meltzer, Richard S., 1948-
IV. Series: Developments in cardiovascular medicine; v. 80.
[DNLM: 1. Coronary Disease-diagnosis. 2. Echocardiography.
WI DE997VME v.80/WG 300 E18)
RC685.C6E18 1988 616.1/2307/543 87-24711
ISBN-13: 978-1-4612-8991-3 e-ISBN-\3: 978-1-4613-1767-8
DOl: 10.1007/978-1-46\3-1767-8
CONTENTS
1. Direct ultrasonic visualization of the coronary arteries
HARVEY FEIGENBAUM
2. Regional and global left ventricular function analysis 13
GERARD KAN AND CEES A. VISSER
3. Echocardiography during reversible ischemia in animal models 33
NATESA G. PAN DIAN
4. Echo-doppler cardiography during percutaneous transluminal coronary
angioplasty 45
CEES A. VISSER AND GERARD KAN
5. Exercise echo cardiography 51
HARVEY FEIGENBAUM
6. Dipyridamole-echocardiography test 65
EUGENIO PICANO
7. Echocardiography in experimental myocardial infarction in animals 77
RICHARD S. MELTZER
8. Myocardial perfusion imaging by contrast two-dimensional
echocardiography 87
FOLKERT J. TEN CATE AND JAN H. CORNEL
9. Echocardiography in the differential diagnosis of patients with chest pain 95
IOANNIS P. PANIDIS AND JOEL MORGAN ROTH
v
vi Contents
10. Acute myocardial infarction in man 107
GERARD KAN AND CEES A. VISSER
11. Evaluation of the effect of thrombolytic therapy on left and right ventricular
function by two-dimensional echocardiography and cineventriculography 123
RAIMUND ERBEL, CLAUS STEUERNAGEL, KARL J. HENRICHS, MICHAEL DREXLER,
GERHARD SCHREINER, BERND HENKEL, SUSANNE MOHR-KAHALY, AND rURGEN MEYER
12. The mechanical complications of acute myocardial infarction 149
PATRICIA E. ASSMANN AND JOS R. T.C. ROELANDT
13. Left ventricular aneurysm and infarct expansion 161
CEES A. VISSER, JACQUES J. KOOLEN, AND GERARD KAN
14. Left ventricular thrombus: diagnosis, anticoagulation, and systemic
embolization 175
RICHARD S. MELTZER AND CEES A. VISSER
15. Doppler echocardiography in coronary artery disease 191
BEN J. M. DELEMARRE AND CEES A. VISSER
16. Epicardial echocardiography: assessment of myocardial effects of ischemia and
revascularization 211
NATHANIEL REICHEK
17. Transesophageal echo cardiography during abdominal aortic surgery 227
JACQUES J. KOOLEN, CEES A. VISSER, JOSEPH A. ODOOM, JAN G. KROMHOUT,
HARRY B. VAN WEZEL, AND AREND J. DUNNING
18. Ultrasonic tissue characterization methods in the diagnosis of coronary artery
disease 235
TAHOR TAK, JOIE P. JONES, SHAHBUDIN H. RAHIMTOOLA, AND P.A.N. CHANDRARATNA
19. Direct epicardial visualization of the coronary arteries 255
GERARD KAN AND CEES A. VISSER
Index 259
CONTRIBUTING AUTHORS
Patricia E. ASSMANN, M.D. Raimund ERBEL, M.D.
Thorax Center, Dijkzigt Hospital II. Medizinische Klinik und Poliklinik
Erasmus University Johannes Gutenberg University, Mainz
Rotterdam FRG
THE NETHERLANDS
Harvey FEIGENBAUM, M.D.
Premindra A. CHANDRARATNA, Krannert Institute of Cardiology
M.D. Indiana University School of Medicine
Indianapolis
Section of Cardiology
Indiana 46223
University of Southern California
USA
Irvine, California 90033, USA
Bernd HENKEL, M.D.
Jan H. CORNEL, M.D.
II. Medizinische Klinik und Poliklinik
Thorax Center, Dijkzigt Hospital
Johannes Gutenberg University, Mainz
Erasmus University, Rotterdam
FRG
THE NETHERLANDS
Karl]. HENRICHS, M.D.
Ben].M. DELEMARRE, M.D.
II. Medizinische Klinik und Poliklinik
Department of Cardiology
Johannes Gutenberg University, Mainz
Academic Medical Center, Amsterdam
FRG
THE NETHERLANDS
Joie P. JONES, Ph.D.
Michael DREXLER, M.D. Department of Radiological Sciences
II. Medizinische Klinik und Poliklinik University of California Irvine, Irvine
Johannes Gutenberg University, Mainz California 92717
FRG USA
Arend]. DUNNING, M.D. Gerard KAN, M.D.
Department of Cardiology Department of Cardiology
Academic Medical Center Amsterdam Academic Medical Center, Amsterdam
THE NETHERLANDS THE NETHERLANDS
vii
viii Contributing authors
Jacques]. KOOLEN, M.D. Eugenio PICANO, M.D.
Department of Cardiology Istituto di Fisiologia Clinica
Academic Medical Center, Amsterdam University of Pis a, Pis a
THE NETHERLANDS ITALY
Shahbudin H. RAHIMTOOLA, M.D.
Jan G. KROMHOUT, M.D.
Section of Cardiology
Department of Surgery
Academic Medical Center, Amsterdam University of Southern California
Los Angeles
THE NETHERLANDS
California 90033
Richard S. MELTZER, M.D. USA
Departments of Medicine and Radiology
Nathaniel REICHEK, M.D.
and the Center for Biomedical
Department of Medicine
Ultrasound
Hospital of the University of
Rochester
Pennsylvania
New York 14642
Philadelphia
USA
Pennsylvania 19102
USA
Jiirgen MEYER, M.D.
II. Medizinische Klinik und Poliklirtik Jos R.T.C. ROELANDT, M.D.
Johannes Gutenberg University, Mainz Thorax Center, Dijkzigt Hospital
FRG Erasmus University, Rotterdam
THE NETHERLANDS
Susanne MOHR-KAHAL Y, M.D.
II. Medizinische Klinik und Poliklinik Gerhard SCHREINER, M.D.
Johannes Gutenberg University, Mainz II. Medizinische Klinik und Poliklinik
FRG Johannes Gutenberg University, Mainz
FRG
Joel MORGANROTH, M.D, Claus STEUERNAGEL, M.D.
Likoff Cardiovascular Institute
II. Medizinische Klinik und Poliklinik
Hahnemann University Hospital
Johannes Gutenberg University, Mainz
Philadelphia FRG
Pennsylvania 19102
USA Tahor TAK, M.D.
Section of Cardiology
Joseph A. ODOOM, M.D. University of Southern California
Department of Anesthesiology Los Angeles, California 90033
Academic Medical Center, Amsterdam USA
THE NETHERLANDS
Folkert J. TEN CATE, M.D.
Thorax Center, Dijkzigt Hospital
Natesa G. PANDIAN, M.D.
Erasmus University, Rotterdam
Non-invasive Cardiac Laboratory
THE NETHERLANDS
Tufts University School of Medicine,
Boston Massachusetts 02111 Harry B. VAN WEZEL, M.D.
USA Department of Anesthesiology
Academic Medical Center, Amsterdam
loannis P. PANIDIS, M.D. THE NETHERLANDS
Likoff Cardiovascular Institute
Hahnemann University Hospital Cees A. VISSER, M.D.
Philadelphia Department of Cardiology
Pennsylvania 19102 Academic Medical Center, Amsterdam
USA THE NETHERLANDS
PREFACE
Some 25 years ago, the coronary care unit concentrated high technology and
the acutely ill patients who might benefit from it in a single, recognizable
space. Since then, that space and its technical equipment have changed, as has
part of its population. Acute ischemia, silent and manifest, occurs within and
outside of the coronary care unit as pain, arrhythmia, or pump failure. Its
detection and treatment require the utilization of many diagnostic techniques
and skills, not the least of which is two-dimensional Doppler echocardio
graphy, which is gaining importance. Future developments, in tandem with
computer technology, may add to this importance by enabling tissue
identification, spatial representation, and Doppler flow mapping.
This book describes the state of the art for the practicing clinician using
Doppler echocardi?graphy at the bedside of patients with acute ischemic
manifestations of coronary heart disease. The first requirement is to move
from the echo laboratory to the coronary care unit, emergency department,
operating room, or catheterization laboratory, using equipment suited for
that purpose. The second, more trying imperative is to secure good cooper
Ition between those treating the acutely ill patient and the investigator who
interferes with his probes. If successful ceeding in both, rewarding results can
be obtained, since echocardiography is a very sensitive and specific tool for
recognizing and quantifying early ischemia.
The editors of this book were among the first to promote this approach by
demonstrating its benefits. Together with similarly oriented investigators on
ix
x Preface
both sides of the Atlantic, they have tried to image the heart under ischemic
stress of many origins and under many circumstances.
Both clinician and investigator will increasingly rely on dependable, non
invasive, on-the-spot assessment of the ischemic heart. I sincerely hope that
this book provides a useful guide into this fascinating and ever-expanding
field.
A.J. Dunning, M.D., F.A.C.C.