Ultrasound In Coronary Artery Disease: Present Role And Future Perspectives (developments In Cardiovascular Medicine)

Today, coronary artery disease is one of the major causes of mortality and morbidity in the Western World. In the last decade many major diagnostic and therapeutic advances have been made, considerably furthering our potential in the management of coronary artery disease. At the same time, a new generation of cardiac tools has appeared. The field which has, perhaps, undergone the most important technological innovations is echocardiography. Nowadays, in fact, the world of ultrasounds ofters the cardiologist a wide range of technical applicatons: two-dimensional real-time imaging, intra-and extra-cardiac Doppler flow measurements, real-time imaging of cardiac struc­ ture and flow by 2D color Doppler, high resolution cardiac imaging by transesophageal echocardiography, tissue characterization by analysis of ultrasound wave characteristics, information on myocardial perfusion by con­ trast echocardiography, etc. Thanks to these technical improvements and to its consequent increased potentiality, echocardiography now plays an impor­ tant and irreplaceable role in the management of all cardiac diseases. In the field of coronary artery disease, echocardiography can reliably be used not only in the acute phases of the disease to derive useful functional and prog­ nostic information but also as a stress diagnostic procedure (thanks to new stress modalities and the continuing improvement of reviewing digital sys­ tems) for the diagnosis of coronary artery disease and for the evaluation of various therapeutic interventions. Furthermore, other promising applications of ultrasounds in this disease are currently being investigated: tissue charac­ coronary artery anatomy terization, myocardial contrast echocardiography, and flow evaluation by specially-designed ultrasound catheters. Front Matter....Pages i-xiii Front Matter....Pages 1-1 Quantitative analysis of wall motion abnormalities....Pages 3-13 Assessment of wall motion by two-dimensional echocardiography....Pages 15-20 Real-time, three-dimensional echocardiography....Pages 21-29 Exercise 2D echocardiography....Pages 31-36 Echocardiography during transesophageal atrial pacing....Pages 37-48 Detection and assessment of the severity of coronary artery disease by dipyridamole echocardiography test....Pages 49-57 The use of color Doppler ultrasound in exercise testing....Pages 59-65 Identification of intraoperative myocardial ischemia by transesophageal echocardiography....Pages 67-81 Silent myocardial ischemia....Pages 83-93 Digital cine loop technology....Pages 95-105 Front Matter....Pages 107-107 Two-dimensional echocardiography in the early management of acute myocardial infarction....Pages 109-119 Left ventricular shape changes and modelling during acute myocardial infarction....Pages 121-131 Two-dimensional echocardiographic quantification of myocardial infarct size....Pages 133-141 Detection and evaluation of left ventricular thrombosis in myocardial infarction....Pages 143-149 Two dimensional echocardiography and Doppler findings in right ventricular infarction....Pages 151-181 The role of cardiac ultrasound in the diagnosis of the ‘surgical’ complications of acute myocardial infarction....Pages 183-196 Prognostic information obtained by 2D-echo- Doppler evaluation in acute myocardial infarction....Pages 197-212 Analysis of left ventricular function in patients with myocardial infarction....Pages 213-229 Stress echocardiography for identifying patients at risk after myocardial infarction....Pages 231-239 Two-dimensional echocardiography for the assessment of therapeutic interventions and long-term follow-up of patients with acute myocardial infarction....Pages 241-254 Front Matter....Pages 107-107 Possibilities of ultrasonic tissue identification in the heart....Pages 255-262 Front Matter....Pages 263-263 Visualization of the coronary arteries by precordial echocardiography....Pages 265-268 Evaluation of proximal left coronary artery anatomy and blood flow using digital transesophageal echocardiography....Pages 269-276 Intra-arterial ultrasonic imaging....Pages 277-284 Intracoronary blood flow velocity, reactive hyperemia and coronary blood flow reserve during and following PTCA....Pages 285-309 Long term result of revascularization after angioplasty....Pages 311-321 Front Matter....Pages 323-323 Pathophysiology of the coronary circulation....Pages 325-350 Contrast agents for myocardial perfusion studies....Pages 351-365 Coronary anatomy and myocardial perfusion: Role of contrast echocardiography....Pages 367-375 Physiological heterogeneity of coronary blood flow in space and time by contrast echocardiography....Pages 377-387 Myocardial contrast echocardiography for the evaluation of coronary flow reserve....Pages 389-396 Back Matter....Pages 397-402