TY - JOUR
T1 - Myocardial contrast echocardiography
T2 - relation of collateral perfusion to extent of injury and severity of contractile dysfunction in a canine model of coronary thrombosis and reperfusion
AU - Cheirif, Jorge B.
AU - Narkiewicz-Jodko, Joanna B.
AU - Hawkins, Hal K.
AU - Bravenec, Joseph S.
AU - Quinones, Miguel A.
AU - Mickelson, Judith K.
N1 - Funding Information:
an Establishedl nvestigatorship( Dr. Mickelson)a nd a Clinician-ScientistA ward (Dr. Cheirif) from the American Heart Association, Dallas, Texas; and the researchw as supportedb y a VeteransA ffairsM erit ReviewG rant (Dr. Mickel-son), Departmento f Veterans Affairs,W ashington,D ,C. Manuscriptr eceivedN ovember1 0,1994;r evisedm anuscriptr eceivedM arch 6, 1995, acceptedM arch 9, 1995.
PY - 1995/8
Y1 - 1995/8
N2 - Objectives. This study sought to determine whether myocardial contrast echocardiography could be used to detect and quantitate collateral blood flow capable of limiting the effects of ischemia in an experimental model of coronary thrombosis and reperfusion. Background. Myocardial contrast echocardiography has been used to assess collateral blood flow in humans, but this technique has not been extensively validated in the experimental laboratory. Methods. Myocardial ischemia occurred after electrically induced left circumflex coronary artery thrombosis in a canine model. Ischemia was intensified by administration of vasodilators. Reperfusion was induced with recombinant tissue-type plasminogen activator. Myocardial perfusion was assessed with contrast echocardiography and radiolabeled microspheres. Infarct size was determined by histochemical staining methods. Myocardial samples were evaluated histologically. Results. The dogs were classified into two groups on the basis of contrast echocardiographic detection of perfusion in the ischemic region: those with (n = 13) and without collateral flow (n = 10). Collateral perfusion detected by contrast echocardiography paralleled changes detected by radiolabeled microspheres during thrombosis and vasodilator administration. A 91% agreement was observed between the two techniques in detecting collateral flow >0.3 mi/min per g (p < 0.0001). Collateral perfusion correlated directly with radial shortening fractions of the ischemic myocardium (p < 0.01). Recovery of function after reperfusion was faster, infarct size was smaller (mean [±SD] 4 ± 1% vs. 11 ± 3%, p = 0.05), and histopathologic injury was less in dogs with than without collateral flow, respectively (p < 0.05). Conclusions. Myocardial contrast echocardiography can identify physiologically significant collateral vessels capable of limiting the degree of ischemic damage during coronary thrombosis. The magnitude of collateral flow and the change in flow induced by vasodilators can be assessed and compares favorably with the microsphere standard.
AB - Objectives. This study sought to determine whether myocardial contrast echocardiography could be used to detect and quantitate collateral blood flow capable of limiting the effects of ischemia in an experimental model of coronary thrombosis and reperfusion. Background. Myocardial contrast echocardiography has been used to assess collateral blood flow in humans, but this technique has not been extensively validated in the experimental laboratory. Methods. Myocardial ischemia occurred after electrically induced left circumflex coronary artery thrombosis in a canine model. Ischemia was intensified by administration of vasodilators. Reperfusion was induced with recombinant tissue-type plasminogen activator. Myocardial perfusion was assessed with contrast echocardiography and radiolabeled microspheres. Infarct size was determined by histochemical staining methods. Myocardial samples were evaluated histologically. Results. The dogs were classified into two groups on the basis of contrast echocardiographic detection of perfusion in the ischemic region: those with (n = 13) and without collateral flow (n = 10). Collateral perfusion detected by contrast echocardiography paralleled changes detected by radiolabeled microspheres during thrombosis and vasodilator administration. A 91% agreement was observed between the two techniques in detecting collateral flow >0.3 mi/min per g (p < 0.0001). Collateral perfusion correlated directly with radial shortening fractions of the ischemic myocardium (p < 0.01). Recovery of function after reperfusion was faster, infarct size was smaller (mean [±SD] 4 ± 1% vs. 11 ± 3%, p = 0.05), and histopathologic injury was less in dogs with than without collateral flow, respectively (p < 0.05). Conclusions. Myocardial contrast echocardiography can identify physiologically significant collateral vessels capable of limiting the degree of ischemic damage during coronary thrombosis. The magnitude of collateral flow and the change in flow induced by vasodilators can be assessed and compares favorably with the microsphere standard.
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U2 - 10.1016/0735-1097(95)80034-E
DO - 10.1016/0735-1097(95)80034-E
M3 - Article
C2 - 7608461
AN - SCOPUS:0029128238
SN - 0735-1097
VL - 26
SP - 537
EP - 546
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -