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Titolo:
INTRAVENOUS METOPROLOL PRECEDING THROMBOLYSIS IN ACUTE THROMBOTIC MYOCARDIAL-INFARCTION IN THE DOG - EFFECTS ON INFARCT SIZE, MYOCARDIAL BLOOD-FLOW, AND LEFT-VENTRICULAR FUNCTION
Autore:
ZMUDKA K; DUBIEL J; VANHAECKE J; FLAMENG W; DEGEEST H;
Indirizzi:
UNIV HOSP GASTHUISBERG,DEPT CARDIOL,HERESTR 49 B-3000 LOUVAIN BELGIUM UNIV HOSP GASTHUISBERG,DEPT CARDIOL B-3000 LOUVAIN BELGIUM UNIV HOSP GASTHUISBERG,DEPT CARDIOVASC SURG B-3000 LOUVAIN BELGIUM NICHOLAS COPERNICUS MED ACAD,DEPT CARDIOL 2 KRAKOW POLAND
Titolo Testata:
Journal of cardiovascular pharmacology
fascicolo: 1, volume: 24, anno: 1994,
pagine: 78 - 86
SICI:
0160-2446(1994)24:1<78:IMPTIA>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
BETA-ADRENERGIC-BLOCKADE; CORONARY-ARTERY REPERFUSION; PROPRANOLOL; ISCHEMIA; REDUCTION; DISEASE; HEART; DRUGS;
Keywords:
INFARCT SIZE LIMITATION; COLLATERAL CORONARY FLOW; METOPROLOL; REGIONAL LEFT VENTRICULAR FUNCTION; THROMBOLYSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
K. Zmudka et al., "INTRAVENOUS METOPROLOL PRECEDING THROMBOLYSIS IN ACUTE THROMBOTIC MYOCARDIAL-INFARCTION IN THE DOG - EFFECTS ON INFARCT SIZE, MYOCARDIAL BLOOD-FLOW, AND LEFT-VENTRICULAR FUNCTION", Journal of cardiovascular pharmacology, 24(1), 1994, pp. 78-86

Abstract

Intravenous (i.v.) metoprolol preceding thrombolysis in an anesthetized dog model of thrombotic occlusion of the anterior descending coronary artery helps limit infarct size (IS). We wished to determine whether these effects are caused at least in part by enhancement of collateral blood flow to the area at risk (AAR). Thrombotic occlusion was provoked by a copper coil technique. We measured intracardiac pressures and their derivatives by catheter-tip micromanometers, cardiac output (CO) by thermodilution method, regional myocardial blood flow (RMBF) by radioactive microspheres technique, global and regional left ventricular (LV) function by ventriculography, and IS with triphenyltetrazoliumat the end of the experiment. Measurements were performed before and after 60-min occlusion and after 30- and 90-min reperfusion. Received fifteen minutes after occlusion, 12 dogs metoprolol 0.3 mg/kg i.v. followed by 0.3 mg/kg/h; 12 received saline. Thrombolysis was performed in all dogs after 60-min occlusion with recombinant tissue-type plasminogen activator (rt-PA) 10 mu g/kg/min for 30 min. Hemodynamic findingswere similar in both groups. During occlusion, collateral flow to total AAR (18.6 +/- 7.5 vs. 11.0 +/- 6.1 ml/min/100 g), to its subepicardial (22.1 +/- 8.1 vs. 12.2 +/- 7.2 ml/min/100 g), midmyocardial (16.0 /- 8.9 vs. 8.0 +/- 5.5 ml/min/100 g), and endocardial(l4.1 +/- 8.1 vs. 7.3 +/- 6.0 ml/min/100 g) layers was higher (p less than or equal to0.03) in metoprolol than in placebo-treated dogs. The ratio of flow of AAR/circumflex region was higher (p less than or equal to 0.03) for total area (0.39 +/- 0.14 vs. 0.23 +/- 0.12), epicardial(0.55 +/- 0.19VS. 0.34 +/- 0.21 ml/min/100 g) and midmyocardial (0.30 +/- 0.16 vs. 0.17) layers. Global ventricular function was comparable in both groups after 90-min reperfusion; the infarct region was akinetic in the metoprolol group and dyskinetic in the placebo group. AAR (41.1 +/- 15.3 vs. 42.4 +/- 12.9 cm(2)) was similar in both groups, and IS (21.6 +/- 20.7 vs. 43.0 +/- 17.3% of AAR, p = 0.014) was smaller in metoprolol-treated dogs. Metoprolol administered i.v. before thrombolysis enhancescollateral blood flow to the AAR, limits IS, and improves regional LVperformance.

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Documento generato il 26/09/20 alle ore 14:08:28