Sonothrombolysis Improves Myocardial Dynamics and Microvascular Obstruction Preventing Left Ventricular Remodeling in Patients With ST Elevation Myocardial Infarction.

التفاصيل البيبلوغرافية
العنوان:	Sonothrombolysis Improves Myocardial Dynamics and Microvascular Obstruction Preventing Left Ventricular Remodeling in Patients With ST Elevation Myocardial Infarction.
المؤلفون:	Aguiar MOD; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.)., Tavares BG; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.)., Tsutsui JM; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.)., Fava AM; University of Nebraska Medical Center, Omaha (A.M.F., A.G., T.R.P.)., Borges BC; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Oliveira MT Jr; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Soeiro A; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Nicolau JC; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Ribeiro HB; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Chiang HP; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.)., Sbano JCN; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.)., Goldsweig A; University of Nebraska Medical Center, Omaha (A.M.F., A.G., T.R.P.)., Rochitte CE; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Lopes BBC; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Ramirez JAF; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Kalil Filho R; Heart Institute (InCor)- University of São Paulo Medical School, Brazil (B.C.B., M.T.O., A.S., J.C.N., H.B.R., C.E.R., B.B.C.L., J.A.F.R., R.K.F.)., Porter TR; University of Nebraska Medical Center, Omaha (A.M.F., A.G., T.R.P.)., Mathias W Jr; Heart Institute (InCor), University of São Paulo Medical School and Fleury Group, Brazil (M.O.D.A., B.G.T., J.M.T., H.P.C., J.C.N.S., W.M.).
المصدر:	Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2020 Apr; Vol. 13 (4), pp. e009536. Date of Electronic Publication: 2020 Apr 21.
نوع المنشور:	Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة:	English
بيانات الدورية:	Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101479935 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1942-0080 (Electronic) Linking ISSN: 19419651 NLM ISO Abbreviation: Circ Cardiovasc Imaging Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Hagerstown, MD Lippincott Williams & Wilkins
مواضيع طبية MeSH:	Ventricular Remodeling, High-Energy Shock Waves/therapeutic use , Mechanical Thrombolysis/methods , Microcirculation/physiology , Percutaneous Coronary Intervention/methods , ST Elevation Myocardial Infarction/physiopathology , ST Elevation Myocardial Infarction/*therapy, Echocardiography ; Female ; Heart/physiopathology ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Treatment Outcome
مستخلص:	Background: It has recently been demonstrated that high-energy diagnostic transthoracic ultrasound and intravenous microbubbles dissolve thrombi (sonothrombolysis) and increase angiographic recanalization rates in patients with ST-segment-elevation myocardial infarction. We aimed to study the effect of sonothrombolysis on the myocardial dynamics and infarct size obtained by real-time myocardial perfusion echocardiography and their value in preventing left ventricular remodeling. Methods: One hundred patients with ST-segment-elevation myocardial infarction were randomized to therapy (50 patients treated with sonothrombolysis and percutaneous coronary intervention) or control (50 patients treated with percutaneous coronary intervention only). Left ventricular volumes, ejection fraction, risk area (before treatment), myocardial perfusion defect over time (infarct size), and global longitudinal strain were determined by quantitative real-time myocardial perfusion echocardiography and speckle tracking echocardiography imaging. Results: Risk area was similar in the control and therapy groups (19.2±10.1% versus 20.7±8.9%; P =0.56) before treatment. The therapy group presented a behavior significantly different than control group over time ( P <0.001). The perfusion defect was smaller in the therapy at 48 to 72 hours even in the subgroup of patients with no recanalization at first angiography (12.9±6.5% therapy versus 18.8±9.9% control; P =0.015). The left ventricular global longitudinal strain was higher in the therapy than control immediately after percutaneous coronary intervention (14.1±4.1% versus 12.0±3.3%; P =0.012), and this difference was maintained until 6 months (17.1±3.5% versus 13.6±3.6%; P <0.001). The only predictor of left ventricular remodeling was treatment with sonothrombolysis: the control group was more likely to exhibit left ventricular remodeling with an odds ratio of 2.79 ([95% CI, 0.13-6.86]; P =0.026). Conclusions: Sonothrombolysis reduces microvascular obstruction and improves myocardial dynamics in patients with ST-segment-elevation myocardial infarction and is an independent predictor of left ventricular remodeling over time.
فهرسة مساهمة:	Keywords: angiography; control group; myocardial infarction; odds ratio; percutaneous coronary intervention; ventricular remodeling
تواريخ الأحداث:	Date Created: 20200422 Date Completed: 20201110 Latest Revision: 20201110
رمز التحديث:	20221213
DOI:	10.1161/CIRCIMAGING.119.009536
PMID:	32312114
قاعدة البيانات:	MEDLINE

View record in Lippincott, Williams & Wilkins

Full Text Finder

الوصف
تدمد:	1942-0080
DOI:	10.1161/CIRCIMAGING.119.009536