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Titolo:
MAGNITUDE AND TIME-COURSE OF MICROVASCULAR OBSTRUCTION AND TISSUE-INJURY AFTER ACUTE MYOCARDIAL-INFARCTION
Autore:
ROCHITTE CE; LIMA JAC; BLUEMKE DA; REEDER SB; MCVEIGH ER; FURUTA T; BECKER LC; MELIN JA;
Indirizzi:
JOHNS HOPKINS UNIV HOSP,DIV CARDIOL,BLALOCK 569,600 N WOLFE ST BALTIMORE MD 21287 JOHNS HOPKINS UNIV,DEPT MED,DIV CARDIOL BALTIMORE MD 00000 JOHNS HOPKINS UNIV,DEPT RADIOL BALTIMORE MD 00000 JOHNS HOPKINS UNIV,DEPT BIOMED ENGN BALTIMORE MD 00000 UNIV LOUVAIN,DEPT MED,DIV CARDIOL BRUSSELS BELGIUM
Titolo Testata:
Circulation
fascicolo: 10, volume: 98, anno: 1998,
pagine: 1006 - 1014
SICI:
0009-7322(1998)98:10<1006:MATOMO>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
NO-REFLOW PHENOMENON; LEFT-VENTRICULAR FUNCTION; CONTRAST ENHANCEMENT; CORONARY FLOW; REPERFUSION; ISCHEMIA; DOG; PERFUSION; THROMBOLYSIS; IMPAIRMENT;
Keywords:
MAGNETIC RESONANCE IMAGING; MYOCARDIAL INFARCTION; MICROCIRCULATION; REPERFUSION; PERFUSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
C.E. Rochitte et al., "MAGNITUDE AND TIME-COURSE OF MICROVASCULAR OBSTRUCTION AND TISSUE-INJURY AFTER ACUTE MYOCARDIAL-INFARCTION", Circulation, 98(10), 1998, pp. 1006-1014

Abstract

Background-Microvascular obstruction within an area of myocardial infarction indicates worse functional recovery and a higher risk of postinfarction complications. After prolonged coronary occlusion, contrast-enhanced MRI identifies myocardial infarction as a hyperenhanced region containing a hypoenhanced core. Because the time course of microvascular obstruction after infarction/reperfusion is unknown, we examined whether microvascular obstruction reaches its full extent shortly after reperfusion or shows significant progression over the following 2 days. Methods and Results-Seven dogs underwent 90-minute balloon occlusion of the left anterior descending coronary artery (LAD) followed by reflow. Gadolinium-DTPA-enhanced MRT performed at 2, 6, and 48 hours after reperfusion was compared with radioactive microsphere blood flow (MBF) measurements and myocardial staining to define microvascular obstruction (thioflavin S) and infarct size (triphenyltetrazolium chloride, TTC). The MRI hypoenhanced region increased 3-fold during 48 hours after reperfusion (3.2+/-1.8%, 6.7+/-4.4%, and 9.9+/-3.2% of left ventricular mass at 2, 6, and 48 hours, respectively, P<0.03) and correlated well with microvascular obstruction (MBF <50% of remote region, r=0.99 and thioflavin S, r=0.93). MRI hyperenhancement also increased (21.7+/-4.0%, 24.3+/-4.6%, and 28.8+/-5.1% at 2, 6, and 48 hours, P<0.006)and correlated well with infarct size by TTC (r=0.92). The microvascular obstruction/infarct size ratio increased from 13.0+/-4.8% to 22.6+/-8.9% and to 30.4+/-4.2% over 48 hours (P=0.024). Conclusions The extent of microvascular obstruction and the infarct size increase significantly over the first 48 hours after myocardial infarction. These results are consistent with progressive microvascular and myocardial injury well beyond coronary occlusion and reflow.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 06:58:01