Utilization of Diagnostic Ultrasound in the Detection and Therapy of Acute Coronary Syndromes

Pre-clinical studies have indicated that, during a continuous infusion of intravenous
perfluorocarbon-containing microbubbles, the ultrasonic power delivered from a diagnostic
ultrasound transducer is capable of restoring microcirculatory flow and improving epicardial
recanalization rates following acute coronary thrombotic occlusions. Since both diagnostic
ultrasound and intravenous infusions of microbubbles are a Class I indication to assess
regional and global left ventricular function and risk area in patients with ST segment
elevation myocardial infarction (STEMI), this pilot study will examine whether diagnostic
assessments of left ventricular function and risk area size impacts epicardial
recanalization rates and infarct size in STEMI.

The aim of this study is to test whether guided high mechanical index impulses from a
diagnostic transducer during a continuous infusion of intravenous microbubbles are capable
of improving microvascular recanalization and epicardial recanalization rates in STEMI, as
assessed by coronary angiography, and recovery of regional microvascular perfusion and
function in the post-infarction period.

Inclusion Criteria:

1. Male or female, age ≥ 30 years.

2. Chest Pain occurring lasting less than six hours from onset, and EKG evidence of an
acute ST segment elevation myocardial infarction.

3. Arrival in the Emergency Department with above inclusion criteria between 7 am and
7pm.

Exclusion Criteria:

1. Known or suspected hypersensitivity to ultrasound contrast agent used for the study.

2. Complicated hemodynamic instability (i.e., NYHA Class IV heart failure, unstable
angina at rest despite medical therapy).

3. Life expectancy of less than two months or terminally ill.

4. Heart transplant recipient, hypertrophic cardiomyopathy, severe valvular disease,
acute myo- or pericarditis.

5. Contraindication to Heart Catheterization

6. Known bleeding diathesis or contraindication to glycoprotein 2b/3a inhibitors or
aspirin.