Abstract:
BACKGROUND:Since myocardial blood flow changes dynamically after reperfusion and since both hyperemia and impairment in microvascular function exist within the acutely reperfused bed, we sought to investigate the role of myocardial contrast echocardiography (MCE) in (1) defining the temporal variability in perfusion patterns after reflow and relating these to microsphere-derived blood flow; (2) differentiating viable from infarcted tissue during different periods of reflow; and (3) defining spatial perfusion patterns within the infarct bed in response to exogenously induced maximal vasodilation and relating these to infarct size and extent of myocardial salvage. METHODS AND RESULTS:Twenty-one dogs with 3 hours of left anterior descending coronary artery occlusion and 2 to 3 hours of reflow were studied. MCE was performed at 15 and 45 minutes and 2 and 3 hours after reflow. It was also performed at either 2 or 3 hours after reflow in the presence of 0.56 mg/kg of dipyridamole. Radiolabeled microsphere-derived blood flow was measured at 15 minutes and 2 and 3 hours after reflow and during dipyridamole effect. Infarct size was measured at the end of the experiment by use of triphenyl tetrazolium chloride. MCE data were processed with color-coding schemes that highlighted differences in myocardial videointensities in proportion to the concentration of microbubbles within the microvasculature. There was significant variability in MCE-defined perfusion patterns after reflow, with contrast defects noted mainly within the endocardium. There were fair and significant (P < .05) correlation (r = -.73 to r = -.55) between MCE defect size and normalized endocardial blood flow. Except at 15 minutes after reflow, there was poor correlation (r = .31 to r = .51) between MCE defect and infarct sizes. Even at 15 minutes after reflow, MCE defect size underestimated infarct size by 50%. In comparison, in the presence of dipyridamole, MCE defect size correlated strongly (r = .87, P < .001) with infarct size and reasonably well with normalized transmural blood flow (r = -.62, P = .04). Moreover, the topography of the MCE perfusion defect reflected the topography of the infarct. CONCLUSIONS:MCE revealed striking temporal heterogeneity in the spatial distribution of myocardial perfusion during postischemia reflow and either significantly underestimated or did not correlate with infarct size during reperfusion. Because of abnormalities in coronary vascular reserve specific to infarcted tissue, MCE in conjunction with intravenous dipyridamole depicted, in vivo, the actual topography of the infarct with remarkable accuracy.
journal_name
Circulationjournal_title
Circulationauthors
Villanueva FS,Glasheen WP,Sklenar J,Kaul Sdoi
10.1161/01.cir.88.6.2596subject
Has Abstractpub_date
1993-12-01 00:00:00pages
2596-606issue
6eissn
0009-7322issn
1524-4539journal_volume
88pub_type
杂志文章相关文献
CIRCULATION文献大全abstract::An enzyme histochemical study of the sinoatrial node, the coronary sinus, and the atrial muscle extending into the anterior mitral valve was performed on human hearts. Investigation of the activity and localization of the structurally bound enzymes was performed by conventional histochemical techniques. Determination ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.72.1.205
更新日期:1985-07-01 00:00:00
abstract::We assessed factors during an initial episode of ventricular fibrillation that may be predictive of recurrence. Of 141 consecutive patients with acute ischemic heart disease who survived an initial episode of ventricular fibrillation, 41 (29%) had recurrent ventricular fibrillation during hospitalization. The incidenc...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.64.6.1163
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:Several of the theories on the pathogenesis of atherosclerosis may be integrated into a single multifactorial one. According to this theory, the most likely sequence of events involved in early atherosclerosis is vascular dysfunction and/or injury, monocyte recruitment and macrophage formation, lipid deposit...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::We have compared casual indirect measurements of arterial pressure obtained 1) by the general practitioner (GP) and 2) in the outpatient clinic (OPC) with 24 hour continuous recording of direct arterial pressure in two selected group of unrestricted patients. 1) Eight asymptomatic, untreated patients with suspected hy...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.51.6.1101
更新日期:1975-06-01 00:00:00
abstract:BACKGROUND:Patients with repaired coarctation are at increased risk of hypertension and cardiovascular disease despite successful repair. We studied the function of conduit arteries in upper and lower limbs of patients late after successful coarctation repair and its relation to age at surgery. METHODS AND RESULTS:Flo...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc37t1.094900
更新日期:2001-09-18 00:00:00
abstract::Diffuse coronary artery disease is frequently untreatable by coronary artery bypass or angioplasty. Many such "no-option" patients have been subjects for trials of angiogenesis using growth factor manipulation or laser injury. We think these novel revascularization strategies are limited by insufficient inflow to puta...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.21.2539
更新日期:2001-05-29 00:00:00
abstract::We used Doppler echocardiography to quantitate the changes in intracardiac blood flow velocities and right and left ventricular stroke volumes in 80 normal human fetuses from 19 to 40 weeks gestation. Blood flow velocity spectra across the aortic, pulmonary, tricuspid, and mitral valves were digitized to obtain peak v...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.6.1208
更新日期:1986-12-01 00:00:00
abstract::Cerebral neurons can tolerate at least 20 min of normothermic ischemic anoxia. Cerebral recovery from more than 5 min of cardiac arrest is hampered by complex secondary derangements of multiple organ systems after reperfusion. There is increasing support of our hypothesis that this "postresuscitation syndrome" include...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:The renin-angiotensin system regulates blood pressure through its effects on vascular tone, renal hemodynamics, and renal sodium and fluid balance. METHODS AND RESULTS:Using data from a large population-based sample of 1488 siblings having a mean age of 14.8 years and belonging to the youngest generation of...
journal_title:Circulation
pub_type: 评论,杂志文章
doi:10.1161/01.cir.97.18.1773
更新日期:1998-05-12 00:00:00
abstract::First heart sound (S1) energy spectra in isovolumic systole, hemodynamics, and angiographic left ventricular wall motion (LVWM) at rest and with atrial pacing were compared in 27 patients who underwent diagnostic cardiac catheterization and angiography because of chest pain. Eighteen patients were found to have corona...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.57.3.593
更新日期:1978-03-01 00:00:00
abstract:BACKGROUND:A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era. METHODS AND RESULTS:We included patients ≥65 yea...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.001882
更新日期:2013-04-23 00:00:00
abstract:BACKGROUND:Recently, it has been shown that stem/progenitor cells may repair damaged/lost endothelial cells in vein grafts and wire-injured arteries. In the present study, we investigated endothelial cell turnover and regeneration in apolipoprotein E (apoE)(-/-)/transgenic mice carrying LacZ genes driven by an endothel...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.746008
更新日期:2008-04-08 00:00:00
abstract:BACKGROUND:The use of bipolar endocardial electrogram characteristics to guide radiofrequency (RF) current catheter ablation of accessory pathways (APs) has been advocated by several investigators. However, the influences of a varying anatomy of the AP and the atrioventricular groove, of different ablative approaches, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.2.884
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Children stable at home with dilated cardiomyopathy remain at risk of death; there is evidence of survival benefit for transplantation out to 4 years postoperatively. The limited supply of donor organs makes risk stratification imperative, but although cardiopulmonary exercise test is well established as a p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.035956
更新日期:2011-10-18 00:00:00
abstract:BACKGROUND:Smooth muscle cell (SMC) migration and proliferation critically influence the clinical course of vascular disease. We tested the effect of the novel small leucine-rich repeat protein podocan on SMC migration and proliferation using a podocan-deficient mouse in combination with a model of arterial injury and ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.004634
更新日期:2013-11-26 00:00:00
abstract:BACKGROUND:Bone marrow implantation (BMI) was shown to enhance angiogenesis in a rat ischemic heart model. This preclinical study using a swine model was designed to test the safety and therapeutic effectiveness of BMI. METHODS AND RESULTS:BM-derived mononuclear cells (BM-MNCs) were injected into a zone made ischemic ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.093817
更新日期:2001-08-28 00:00:00
abstract:BACKGROUND:Epinephrine has been the mainstay for cardiac resuscitation for more than 30 years. Its vasopressor effect by which it increases coronary perfusion pressure is likely to favor initial resuscitation. Its beta-adrenergic action, however, may have detrimental effects on postresuscitation myocardial function whe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.10.3089
更新日期:1995-11-15 00:00:00
abstract:BACKGROUND:Associations between left ventricular (LV) geometry and the insulin resistance syndrome have been found, mostly in small studies of middle-aged hypertensives. The purpose of this study was to elucidate these associations through the use of a large sample of elderly men. METHODS AND RESULTS:We investigated 4...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.22.2595
更新日期:2000-06-06 00:00:00
abstract:BACKGROUND:Functional mitral regurgitation (MR) is common in patients with heart failure and left ventricular (LV) dysfunction, and its severity may vary over time, depending primarily on the loading conditions. Because dynamic changes in the severity of functional MR may affect forward stroke volume, we hypothesized t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000028812.98083.d9
更新日期:2002-09-10 00:00:00
abstract:BACKGROUND:It is unclear whether increased left ventricular (LV) mass in overweight individuals is related to their adiposity or to greater fat-free mass (FFM). METHODS AND RESULTS:We compared echocardiographic LV mass to FFM and adipose body mass by bioelectric impedance and to anthropometric measurements in 3107 Ame...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.23.2538
更新日期:1998-12-08 00:00:00
abstract:BACKGROUND:Lung hypoplasia and persistent pulmonary hypertension of the newborn limit survival in congenital diaphragmatic hernia (CDH). Unlike other diseases resulting in persistent pulmonary hypertension of the newborn, infants with CDH are refractory to inhaled nitric oxide (NO). Nitric oxide mediates pulmonary vaso...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.845909
更新日期:2011-05-17 00:00:00
abstract:BACKGROUND:Ischemic mitral regurgitation (MR) was first ascribed to papillary muscle (PM) contractile dysfunction. Current theories include apical leaflet tethering caused by left ventricular (LV) distortion, but PM dysfunction is still postulated and commonly diagnosed. PM contraction, however, parallels apical tether...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc4101.097112
更新日期:2001-10-16 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is frequently encountered in patients with heart failure (HF) and is also a predictor of morbidity and mortality in this population. Recent experimental studies have shown electrical and structural atrial remodeling with increased fibrosis in animals with HF and have suggested a prev...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000072793.81076.D4
更新日期:2003-06-17 00:00:00
abstract:BACKGROUND:The hypoxia-inducible transcription factor (HIF) subunits are destabilized via the O(2)-dependent prolyl hydroxylase domain proteins (PHD1, PHD2, and PHD3). We investigated whether inhibition of PHDs via upregulating HIF might promote postischemic neovascularization. METHODS AND RESULTS:Mice with right femo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.813303
更新日期:2009-07-07 00:00:00
abstract:BACKGROUND:Early childhood introduction of nutritional habits aimed at atherosclerosis prevention reduces children's serum total cholesterol concentration, but its effect on vascular endothelial function is unknown. METHODS AND RESULTS:Between 1990 and 1992, we randomized healthy 7-month-old infants (n=1062) to interv...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.105.583195
更新日期:2005-12-13 00:00:00
abstract::Acute myocardial ischemia leads to a gradual increase in beta-adrenergic receptors at the cell surface. This increase occurs rapidly after onset of global ischemia (15 minutes) and persists even after prolonged periods of global ischemia. This alteration can be observed both in vivo and in vitro in isolated perfused h...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:The cyclin-dependent kinase inhibitors (CKIs) have different patterns of expression in vascular diseases. The Kip/Cip CKIs, p27(Kip1) and p21(Cip1), are upregulated during arterial repair and negatively regulate the growth of vascular smooth muscle cells (VSMCs). In contrast, the Ink CKI, p16(Ink4), is not e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.17.2022
更新日期:2000-05-02 00:00:00
abstract:BACKGROUND:Pulmonary veno-occlusive disease is caused by excessive cell proliferation and fibrosis, which obliterate the lumen of pulmonary venules, leading to pulmonary hypertension, right ventricular failure, and death. This condition has no effective treatment and a 5-year survival of <5%. Understanding the mechanis...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.007822
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Drug-eluting stents have shown promising antirestenotic effects in clinical trials. Non-stent-based local delivery of antiproliferative drugs may offer additional flexibility and also reach vessel areas beyond the immediate stent coverage. The aim of the present study was to evaluate a novel method of local ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000138929.71660.E0
更新日期:2004-08-17 00:00:00
abstract:BACKGROUND:Mitral regurgitation (MR) due to mitral valve prolapse (MVP) is often treatable by surgical repair. However, the very long-term (>10-year) durability of repair in both anterior leaflet prolapse (AL-MVP) and posterior leaflet prolapse (PL-MVP) is unknown. METHODS AND RESULTS:In 917 patients (aged 65+/-13 yea...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc37t1.094903
更新日期:2001-09-18 00:00:00