TY - JOUR
T1 - The clinical implications of no reflow demonstrated with intravenous perfluorocarbon containing microbubbles following restoration of thrombolysis in myocardial infarction (TIMI) 3 flow in patients with acute myocardial infarction
AU - Porter, Thomas R.
AU - Li, Shouping
AU - Oster, Rebecca
AU - Deligonul, Ubeydullah
PY - 1998/11/15
Y1 - 1998/11/15
N2 - Intravenous injections or infusions of perfluorocarbon-exposed sonicated dextrose albumin microbubbles were given 2.4 ± 1.6 days following acute myocardial infarction to 45 consecutive patients. Patients were divided into 3 groups: patients with Thrombolysis In Myocardial Infarction (TIMI) grade 3 angiographic flow but persistent myocardial contrast defects by echocardiography (no reflow), patients with TIMI 3 flow and myocardial contrast enhancement (reflow), and patients with TIMI grade 0 to 2 flow in the infarct vessel. Thirty-five patients had TIMI 3 flow at the time of contrast study. Of these, 25 had evidence of reflow with intravenous contrast, whereas 10 (29%) still had contrast defects. At follow-up, end- systolic volume index decreased significantly in patients who exhibited reflow (21 ± 8 ml/m2 at baseline to 18 ± 8 ml/m2 at follow-up; p = 0.04), whereas those with no reflow had a significant increase (26 ± 9 ml/m2 at baseline to 32 ± 9 ml/m2 at follow-up; p = 0.006). A persistent contrast defect in the infarct zone demonstrated with intravenous ultrasound contrast following restoration of TIMI grade 3 flow in the infarct vessel identified patients likely to have deterioration in both regional and global systolic function.
AB - Intravenous injections or infusions of perfluorocarbon-exposed sonicated dextrose albumin microbubbles were given 2.4 ± 1.6 days following acute myocardial infarction to 45 consecutive patients. Patients were divided into 3 groups: patients with Thrombolysis In Myocardial Infarction (TIMI) grade 3 angiographic flow but persistent myocardial contrast defects by echocardiography (no reflow), patients with TIMI 3 flow and myocardial contrast enhancement (reflow), and patients with TIMI grade 0 to 2 flow in the infarct vessel. Thirty-five patients had TIMI 3 flow at the time of contrast study. Of these, 25 had evidence of reflow with intravenous contrast, whereas 10 (29%) still had contrast defects. At follow-up, end- systolic volume index decreased significantly in patients who exhibited reflow (21 ± 8 ml/m2 at baseline to 18 ± 8 ml/m2 at follow-up; p = 0.04), whereas those with no reflow had a significant increase (26 ± 9 ml/m2 at baseline to 32 ± 9 ml/m2 at follow-up; p = 0.006). A persistent contrast defect in the infarct zone demonstrated with intravenous ultrasound contrast following restoration of TIMI grade 3 flow in the infarct vessel identified patients likely to have deterioration in both regional and global systolic function.
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U2 - 10.1016/S0002-9149(98)00597-9
DO - 10.1016/S0002-9149(98)00597-9
M3 - Article
C2 - 9832089
AN - SCOPUS:0032533434
VL - 82
SP - 1173
EP - 1177
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 10
ER -