Contrast Ultrasound, Sonothrombolysis and Sonoperfusion in Cardiovascular Disease: Shifting to Theragnostic Clinical Trials.
Contrast Ultrasound, Sonothrombolysis and Sonoperfusion in Cardiovascular Disease: Shifting to Theragnostic Clinical Trials.
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DOI：
10.1016/j.jcmg.2021.07.028
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Kamp O
中科院分区：
文献类型：
--
作者：
El Kadi S;Porter TR;Verouden NJW;van Rossum AC;Kamp O
超声造影在心血管医学中有多种应用，既可以诊断心血管疾病，也可以提供预后信息。血管内对比微泡的可视化是基于声空化；声空化是导致反射超声波变化的特征振荡。在高功率下，这种声学反应产生足够的剪切力，能够增强动脉粥样硬化性血栓性心血管疾病(超声灌流)中的内皮依赖性血流灌注。超声作用下微泡的振荡和坍塌也会导致微流和喷射，从而使血栓碎裂(超声溶栓)。一些临床前研究的重点是确定最佳的诊断超声设置和治疗方案。临床试验已经在急性心肌梗死、中风和外周动脉疾病中进行，结果往往有所改善。在接下来的几年里，正在进行的临床试验的结果，以及在声溶栓和声灌流方面的创新和改进，将决定这种诊断技术是否会成为再灌注治疗的有价值的补充。
Contrast ultrasound has a variety of applications in cardiovascular medicine, both in diagnosing cardiovascular disease as well as providing prognostic information. Visualization of intravascular contrast microbubbles is based on acoustic cavitation; the characteristic oscillation that results in changes in the reflected ultrasound waves. At high power, this acoustic response generates sufficient shear that is capable of enhancing endothelium-dependent perfusion in atherothrombotic cardiovascular disease (sonoperfusion). The oscillation and collapse of microbubbles in response to ultrasound also induces microstreaming and jetting that can fragment thrombus (sonothrombolysis). Several pre-clinical studies have focused on identifying optimal diagnostic ultrasound settings and treatment regimens. Clinical trials have been performed in acute myocardial infarction, stroke and peripheral arterial disease often with improved outcome. In the forthcoming years, results of ongoing clinical trials along with innovation and improvements in sonothrombolysis and sonoperfusion will determine whether this theragnostic technique will settle as a valuable addition to reperfusion therapy.
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