This study was carried out to image subendocardial myocardial blood flow (SMBF) by
dye-staining cardioscopy (DSC) in patients with
coronary artery disease.In patients with epicardial
coronary artery disease, SMBF plays a direct and critical role in determining the extent and severity of cardiac function and symptoms. If SMBF could be clinically imaged instantaneously, the effects of medical and interventional treatment on it can be directly evaluated. However, there are no clinically available methods for direct and real-time imaging of SMBF. Twenty-three patients [6 with
chest pain syndrome (CPS); 3 with vasospastic
angina pectoris (VSA); 9 with
angina pectoris due to organic
coronary stenosis (AP); 5 with old
myocardial infarction OMI)] underwent DSC of the left ventricle by selective intracoronary injection of 1 mL of 2.5%
Evans blue dye solution (EB). Five patients with acute
myocardial infarction (AMI) underwent DSC before and after coronary
stent deployment. The endocardial surface was stained diffusely blue with EB indicating normal blood flow in patients with CPS; stained in a patchy fashion indicating patchy blood flow in patients with VSA; and stained in a patchy fashion or not stained indicating patchy or no blood flow in those with AP and OMI. Myocardial staining with EB was observed after coronary
stent deployment in all patients with AMI, indicating restoration of the SMBF. It is evident that SMBF could be imaged by DSC. This imaging modality is useful for the evaluation of
therapies and accurate guidance of transendocardial
therapies of the ischemic myocardium.