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Microvascular recovery with ultrasound in myocardial infarction post-PCI trial.
Li, Shouqiang; Hovseth, Chad; Xie, Feng; Kadi, Soufiane El; Kamp, Otto; Goldsweig, Andrew Michael; Mathias, Wilson; Azevedo, Luciene Ferreira; Porter, Thomas Richard.
Afiliación
  • Li S; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Hovseth C; Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
  • Xie F; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Kadi SE; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Kamp O; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres - Location VUmc, Amsterdam, Netherlands.
  • Goldsweig AM; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres - Location VUmc, Amsterdam, Netherlands.
  • Mathias W; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Azevedo LF; Department of Cardiovascular Medicine, Baystate Medical Center and University of Massachusetts-Baystate, Springfield, Massachusetts, USA.
  • Porter TR; Department of Echocardiography, Heart Institute, University of São Paulo, São Paulo, Brazil.
Echocardiography ; 41(6): e15860, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38889076
ABSTRACT

PURPOSE:

Persistent microvascular obstruction (MVO) after successful percutaneous coronary intervention (PCI) in acute ST segment elevation myocardial infarction (STEMI) has been well-described. MVO predicts lack of recovery of left ventricular function and increased mortality. Sonothrombolysis utilizing diagnostic ultrasound induced cavitation of commercially available microbubble contrast has been effective at reducing infarct size and improving left ventricular ejection fraction (LVEF) when performed both pre- and post-PCI. However, the effectiveness of post-PCI sonothrombolysis alone after successful PCI has not been demonstrated.

METHODS:

A prospective randomized controlled trial was performed in 50 consecutive consenting patients with anterior STEMI who underwent a continuous microbubble infusion immediately following successful PCI. Intermittent high mechanical index (MI) impulses were applied only in the sonthrombolysis group. Delayed enhancement magnetic resonance imaging (MRI) was performed at 48 h and again at 6-8 weeks to assess for differences in infarct size, LVEF, and MVO.

RESULTS:

There were no differences between groups in age, gender, and cardiovascular risk factors. Significant (> 2 segments) MVO following successful PCI was observed in 66% of patients. Although sonothrombolysis reduced the extent of MVO acutely, there were no differences in infarct size, LVEF, or extent of MVO by MRI at 48 h. Twenty-eight patients returned for a follow up MRI at 6-8 weeks. LVEF improved only in the sonothrombolysis group (∆LVEF 7.81 ± 4.57% with sonothrombolysis vs. 1.77 ± 7.02% for low MI only, p = .011).

CONCLUSION:

Post-PCI sonothrombolysis had minimal effect on reducing myocardial infarct size but improved left ventricular systolic function in patients with acute anterior wall STEMI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Intervención Coronaria Percutánea Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Echocardiography Asunto de la revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Intervención Coronaria Percutánea Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Echocardiography Asunto de la revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos