Noninvasive transthoracic low frequency ultrasound augments thrombolysis in a canine model of acute myocardial infarction - Evaluation of the extent of ST-segment resolution
Noninvasive transthoracic low frequency ultrasound augments thrombolysis in a canine model of acute myocardial infarction - Evaluation of the extent of ST-segment resolution
复制标题
DOI：
10.1023/a:1011964904848
复制
发表时间：
2001-05-01
影响因子：
4
通讯作者：
Siegel, RJ
中科院分区：
文献类型：
--
作者：
Birnbaum, Y;Luo, H;Siegel, RJ
背景资料：最近，它已被证明，经皮递送超声结合组织纤溶酶原激活剂（tPA）是更有效的再通急性血栓犬冠状动脉比单独的tPA。在本研究中，我们调查了部分（大于或等于50%）和完成实验性急性心肌梗死犬的胸导联ST段抬高分辨率大于或等于70%，这些犬接受了组织纤溶酶原激活剂（tPA）单独治疗或与高强度低频非侵入性经皮给药联合治疗。方法：24只犬，在左前降支（LAD）中段用电击法造成血栓性闭塞。所有犬均静脉给予肝素和tPA。将狗随机分配至单独的tPA（n=12）或组合的tPA和连续经皮超声（US）递送（n=12）。在1）基线，2）冠状动脉闭塞后治疗开始前，3）冠状动脉造影显示冠状动脉再通时（或在治疗开始后90分钟，如果再灌注在此之前没有发生）和4）90分钟后记录心电图。结果：tPA组和US组在基线时ST段振幅相当。在开始治疗前，美国组的ST段抬高总和往往较高。在再灌注时和90分钟后，US组ST段振幅总和有小于tPA组的趋势（p
Background: Recently it has been demonstrated that transcutaneous delivery of ultrasound combined with tissue plasminogen activator (tPA) is more effective than tPA alone in recanalizing acutely thrombosed canine coronary arteries. In the present study, we investigated the incidence of partial (greater than or equal to 50%) and complete (greater than or equal to 70%) ST-segment elevation resolution in the precordial leads of dogs with experimental acute myocardial infarction that were treated with tissue plasminogen activator (tPA) alone or in combination with noninvasive transcutaneous delivery of high-intensity low frequency (27[emsp3 ]kHz) ultrasound.Methods: Thrombotic coronary occlusions were induced in the midportion of left anterior descending (LAD) coronary artery by electrical injury in 24 dogs. All dogs were given intravenous heparin and tPA. Dogs were randomized to tPA alone (n=12) or combined tPA and adjunctive transcutaneous ultrasound (US) delivery (n=12). Electrocardiograms were recorded at 1) baseline, 2) after coronary occlusion just before initiation of therapy, 3) when coronary angiography showed recanalization of the coronary artery (or at 90 minutes after initiation of therapy if reperfusion did not occur before then) and 4) 90 minutes later. ST amplitude was measured in all 6 precordial leads.Results: ST-segment amplitude at baseline was comparable between the tPA and the US group. Before initiation of therapy, sum of ST-segment elevation tended to be higher in the US group. At reperfusion and 90 minutes thereafter, sum of ST-segment amplitude tended to be smaller for the US group than in the tPA group (p