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Titolo:
alpha-adrenergic blockade improves recovery of myocardial perfusion and function after coronary stenting in patients with acute myocardial infarction
Autore:
Gregorini, L; Marco, J; Kozakova, M; Palombo, C; Anguissola, GB; Marco, I; Bernies, M; Cassagneau, B; Distante, A; Bossi, IM; Fajadet, J; Heusch, G;
Indirizzi:
Ctr Cardiol Interventionelle, Clin Pasteur, Toulouse, France Ctr Cardiol Interventionelle Toulouse France Pasteur, Toulouse, France Univ Milan, IRCCS, Osped Maggiore, Clin Med Gen, I-20122 Milan, Italy UnivMilan Milan Italy I-20122 giore, Clin Med Gen, I-20122 Milan, Italy CNR, Inst Clin Physiol, I-56100 Pisa, Italy CNR Pisa Italy I-56100CNR, Inst Clin Physiol, I-56100 Pisa, Italy Univ Essen Gesamthsch Klinikum, Abt Pathophysiol, D-4300 Essen, Germany Univ Essen Gesamthsch Klinikum Essen Germany D-4300 -4300 Essen, Germany
Titolo Testata:
CIRCULATION
fascicolo: 4, volume: 99, anno: 1999,
pagine: 482 - 490
SICI:
0009-7322(19990202)99:4<482:ABIROM>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; ARTERY FLOW VELOCITY; BLOOD-FLOW; INTRAVENOUS STREPTOKINASE; DOPPLER FLOW; NO-REFLOW; REPERFUSION; ANGIOPLASTY; ISCHEMIA; VASOCONSTRICTION;
Keywords:
myocardial infarction; nervous system, autonomic; vasoconstriction; regional blood flow; receptors, adrenergic, alpha;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
55
Recensione:
Indirizzi per estratti:
Indirizzo: Gregorini, L Univ Milan, Clin Med Gen, Via Francesco Sforza 35, I-20122 Milan, Italy Univ Milan Via Francesco Sforza 35 Milan Italy I-20122 Italy
Citazione:
L. Gregorini et al., "alpha-adrenergic blockade improves recovery of myocardial perfusion and function after coronary stenting in patients with acute myocardial infarction", CIRCULATION, 99(4), 1999, pp. 482-490

Abstract

Background-AMI reperfusion by thrombolysis does not improve TIMI flow and LV function. The role of infarct-related artery (IRA) stenosis and superimposed changes in coronary vasomotor tone in maintaining LV dysfunction must be elucidated. Methods and Results-Forty patients underwent diagnostic angiography 24 hours after thrombolysis, Seventy-two hours after thrombolysis, the culprit lesion was dilated with coronary stenting. During angioplasty, LV function was monitored by transesophageal echocardiography, Percent regional systolic thickening was quantitatively assessed before PTCA, soon after stenting, 15minutes after stenting, and after phentolamine 12 mu g/kg IC (n=10), the alpha(1)-blocker urapidil 600 mu g/kg IV (n=10), or saline (n=10), Ten patients pretreated with beta-blockers received urapidil 10 mg IC. Coronary stenting significantly improved thickening in IRA-dependent and in non-IRA-dependent myocardium (from 27+/-15% to 38+/-16% and from 40+/-15% to 45+/-15%, respectively). Simultaneously, TIMI frame count decreased from 39+/-11 and 40+/-11 in the IRA and non-IRA, respectively, to 23+/-10 and 25+/-7 (P<0.05). Fifteen minutes after stenting, thickening worsened in both IRA- and non-IRA-dependent myocardium (to 19+/-14% and 28+/-14%, P<0.05), and TIMI frame count returned, in both the IRA and non-IRA, to the values obtained before stenting, Phentolamine and urapidil increased thickening to 36+/-17% and 41+/-14% in IRA and to 48+/-11% and 49+/-17% in non-IRA myocardium respectively, and TIMI frame count decreased to 16+/-6 and to 17+/-5, respectively. Changes were attenuated with beta-blocker pretreatment. Conclusions-Our finding that alpha-adrenergic blockade attenuates vasoconstriction and postischemic LV dysfunction supports the hypothesis of an important role of neural mechanisms in this phenomenon.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 20:06:14