Document Detail


Detection of perfusion defects during coronary occlusion and myocardial reperfusion after thrombolysis by intravenous administration of the echo-enhancing agent BR1.
MedLine Citation:
PMID:  9517556     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to detect myocardial perfusion defects as a result of coronary occlusion and myocardial reperfusion after thrombolysis with intravenous (i.v.) administration of the echo contrast agent BR1 (Bracco Research, Switzerland), which consists of microbubbles (median diameter 2.5 microm) containing sulfur exafluoride in a phospholipidic shell. To generate a coronary thrombosis, a copper coil was advanced into the left circumflex coronary artery in eight anesthetized dogs with opened chest cavities. Coronary occlusion occurred 18 +/- 10 minutes after the insertion of the coil and was documented both by an electromagnetic flow meter (as zero blood flow) and by radiolabeled microspheres (as myocardial perfusion defect). After 2 hours of occlusion, streptokinase was infused i.v.; reperfusion was documented by both the flow-meter and microspheres. Left ventricular cavity enhancement was apparent after all contrast injections. Peak cavity intensity did not increase with dose and was not affected by signal processing (suggesting signal saturation), whereas the duration of contrast effect significantly increased with the dose (from 26 +/- 16 to 147 +/- 74 seconds). Myocardial contrast intensity also increased after contrast (from 15 +/- 12 to 21 +/- 18 gray level/pixel, p < 0.001). Contrast echo detected myocardial perfusion defects (corresponding to 17% +/- 11% of LV cross-sectional area) in all the injections performed during coronary occlusion and detected myocardial reperfusion with a sensitivity of 50% versus microspheres. The extent of perfusion defects by contrast echo showed a good correlation with microspheres (r = 0.73). Myocardial reperfusion was not detected by changes in heart rate, aortic pressure, pulmonary arterial pressure, cardiac output, left ventricular fractional area change, or wall-motion score index. Hemodynamic parameters were not affected by contrast injections. Thus, the i.v. administration of BR1 allows us to accurately detect myocardial perfusion defects during coronary occlusion and, to a lesser extent, myocardial reperfusion after thrombolysis.
Authors:
D Rovai; V Lubrano; C Vassalle; M Paterni; C Marini; M Kozakova; M Castellari; L Taddei; M G Trivella; A Distante; A N DeMaria; A L'Abbate
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  11     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-05-14     Completed Date:  1998-05-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  169-80     Citation Subset:  IM    
Affiliation:
C.N.R. Clinical Physiology Institute, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Animals
Contrast Media / administration & dosage*
Coronary Thrombosis / drug therapy,  ultrasonography
Dogs
Echocardiography*
Female
Hemodynamics / drug effects
Male
Myocardial Reperfusion*
Sulfur Hexafluoride / administration & dosage,  diagnostic use*,  pharmacology
Thrombolytic Therapy*
Chemical
Reg. No./Substance:
0/Contrast Media; 2551-62-4/Sulfur Hexafluoride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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