| Coronary reserve abnormalities in the infarcted myocardium. Assessment of myocardial viability immediately versus late after reflow by contrast echocardiography. | |
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MedLine Citation:
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PMID: 8772698 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The aim of this study was to determine whether myocardial contrast echocardiography (MCE) during exogenous vasodilation can accurately delineate infarct size, and hence the extent of myocardial viability, both immediately (15 minutes) and late (3 hours) after reperfusion when postreflow coronary hyperema is still present. METHODS AND RESULTS: Twenty-one open-chest anesthetized dogs underwent 3 to 6 hours of coronary occlusion followed by reperfusion. MCE was performed 15 minutes after reflow before and during infusion of 0.2 mg.kg-1.min-1 adenosine i.v.. In 12 dogs, infarct size was measured at this time. In the remaining 9 dogs, reperfusion was continued for 3 hours, when MCE was repeated before and after an infusion of 0.56 mg.kg-1.min-1 dipyridamole i.v. and infarct size was measured. In the absence of adenosine, MCE perfusion defect at 15 minutes underestimated infarct sizes at both 15 minutes and 3 hours, whereas in the presence of adenosine, the estimate of infarct size was more accurate. Similarly, in the absence of dipyridamole, although MCE perfusion defect underestimated infarct size (both measured 3 hours after reflow), in the presence of dipyridamole, the estimate of infarct size was more accurate. CONCLUSIONS: By unmasking abnormalities in flow reserve within the infarct bed, MCE in conjunction with coronary vasodilators can accurately predict infarct size both 15 minutes and 3 hours after reperfusion. Thus, MCE can be used for assessing the extent of myocardial viability both immediately and late after reperfusion when postreflow coronary hyperemia is still present. |
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Authors:
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F S Villanueva; G Camarano; S Ismail; N C Goodman; J Sklenar; S Kaul |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 94 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1996 Aug |
Date Detail:
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Created Date: 1996-10-10 Completed Date: 1996-10-10 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 748-54 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Division, University of Virginia School of Medicine, Charlottesville 22908, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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pharmacology Animals Coronary Circulation* Dipyridamole / pharmacology Dogs Echocardiography* Heart / drug effects, physiopathology Myocardial Infarction / pathology, physiopathology*, ultrasonography* Myocardial Reperfusion Myocardium / pathology* Regression Analysis Time Factors Vasodilation |
| Grant Support | |
ID/Acronym/Agency:
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R01-HL-48890/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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58-32-2/Dipyridamole; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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