MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY - RELATION OF COLLATERAL PERFUSION TO EXTENT OF INJURY AND SEVERITY OF CONTRACTILE DYSFUNCTION IN A CANINE MODEL OF CORONARY-THROMBOSIS AND REPERFUSION

被引:40
作者
CHEIRIF, J
NARKIEWICZJODKO, JB
HAWKINS, HK
BRAVENEC, JS
QUINONES, MA
MICKELSON, JK
机构
[1] VET AFFAIRS MED CTR,CARDIOL SECT IIIB,HOUSTON,TX 77030
[2] BAYLOR COLL MED,DEPT PATHOL,HOUSTON,TX 77030
[3] BAYLOR COLL MED,DEPT MED,CARDIOL SECT,HOUSTON,TX 77030
关键词
D O I
10.1016/0735-1097(95)80034-E
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 ml/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 bow induced by vasodilators can be assessed and compares favorably with the microsphere standard.
引用
收藏
页码:537 / 546
页数:10
相关论文
共 33 条
[1]  
Bolli R, 1982, Cardiovasc Res Cent Bull, V21, P1
[2]   TIME COURSE AND DETERMINANTS OF RECOVERY OF FUNCTION AFTER REVERSIBLE ISCHEMIA IN CONSCIOUS DOGS [J].
BOLLI, R ;
ZHU, WX ;
THORNBY, JI ;
ONEILL, PG ;
ROBERTS, R .
AMERICAN JOURNAL OF PHYSIOLOGY, 1988, 254 (01) :H102-H114
[3]   ABILITY OF DIPYRIDAMOLE-THALLIUM-201 IMAGING ONE TO 4 DAYS AFTER ACUTE MYOCARDIAL-INFARCTION TO PREDICT IN-HOSPITAL AND LATE RECURRENT MYOCARDIAL ISCHEMIC EVENTS [J].
BROWN, KA ;
OMEARA, J ;
CHAMBERS, CE ;
PLANTE, DA .
AMERICAN JOURNAL OF CARDIOLOGY, 1990, 65 (03) :160-167
[4]   ASSESSMENT OF REGIONAL MYOCARDIAL PERFUSION BY CONTRAST ECHOCARDIOGRAPHY .2. DETECTION OF CHANGES IN TRANSMURAL AND SUBENDOCARDIAL PERFUSION DURING DIPYRIDAMOLE-INDUCED HYPEREMIA IN A MODEL OF CRITICAL CORONARY STENOSIS [J].
CHEIRIF, J ;
ZOGHBI, WA ;
BOLLI, R ;
ONEILL, PG ;
HOYT, BD ;
QUINONES, MA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 14 (06) :1555-1565
[5]   MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY - RELATION BETWEEN ONLINE AND OFF-LINE ASSESSMENT OF MYOCARDIAL PERFUSION [J].
CHEIRIF, J ;
NARKIEWICZJODKO, JB ;
BRAVENEC, JS ;
DSA, A ;
QUINONES, MA ;
MICKELSON, JK .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 1993, 10 (05) :471-484
[6]  
CHEIRIF-B J, 1992, Journal of the American College of Cardiology, V19, P1343
[7]   DEFINING THE ANATOMIC PERFUSION BED OF AN OCCLUDED CORONARY-ARTERY AND THE REGION AT RISK TO INFARCTION - A COMPARATIVE-STUDY IN THE BABOON, PIG AND DOG [J].
GEARY, GG ;
SMITH, GT ;
MCNAMARA, JJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1981, 47 (06) :1240-1247
[8]  
GENSINI GG, 1969, AM J CARDIOL, V24, P393
[9]   CONTRAST ECHOCARDIOGRAPHIC MAPPING OF COLLATERALIZED MYOCARDIUM IN HUMANS BEFORE AND AFTER CORONARY ANGIOPLASTY [J].
GRILL, HP ;
BRINKER, JA ;
TAUBE, JC ;
WALFORD, GD ;
MIDEI, MG ;
FLAHERTY, JT ;
WEISS, JL .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 16 (07) :1594-1600
[10]   INFLUENCE OF CORONARY COLLATERAL VESSELS ON MYOCARDIAL INFARCT SIZE IN HUMANS - RESULTS OF PHASE-I THROMBOLYSIS IN MYOCARDIAL-INFARCTION (TIMI) TRIAL [J].
HABIB, GB ;
HEIBIG, J ;
FORMAN, SA ;
BROWN, BG ;
ROBERTS, R ;
TERRIN, ML ;
BOLLI, R .
CIRCULATION, 1991, 83 (03) :739-746