PERIPHERAL INTRAVENOUS MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY USING A 2-PERCENT DODECAFLUOROPENTANE EMULSION - IDENTIFICATION OF MYOCARDIAL RISK AREA AND INFARCT SIZE IN THE CANINE MODEL OF ISCHEMIA
PERIPHERAL INTRAVENOUS MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY USING A 2-PERCENT DODECAFLUOROPENTANE EMULSION - IDENTIFICATION OF MYOCARDIAL RISK AREA AND INFARCT SIZE IN THE CANINE MODEL OF ISCHEMIA
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DOI：
10.1016/0735-1097(95)00306-1
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发表时间：
1995-11-01
影响因子：
24
通讯作者：
VELASCO, CE
中科院分区：
文献类型：
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作者：
GRAYBURN, PA;ERICKSON, JM;VELASCO, CE
目标。本研究评估了2%十二氟戊烷（EchoGen），一种静脉超声心动图造影剂，在犬心肌缺血模型中识别心肌危险区域和梗死面积的准确性。心肌对比超声心动图可以确定心肌危险区域和梗死面积，但需要在人类冠状动脉内注射。可以通过外周静脉注射给药的药物的开发可以使床边心肌超声造影评估危险区域、梗死面积和再灌注。采用了两种方案。方案1评估心肌对比超声心动图的准确性，在犬局部心肌缺血模型中，静脉注射十二氟戊烷来确定心肌危险区域和梗死面积，对比肉眼病理标本用monastral蓝染色来确定危险区域，用三苯基四唑氯来确定坏死区域。方案2评估了反复注射十二氟戊烷（0.5 ml/kg体重，间隔30分钟注射4次或间隔10分钟注射8次）对心肌血流和血流动力学变量的影响。结果。心肌超声造影准确地确定了危险区域和梗死面积（与三苯四唑氯相比r = 0.96）。心肌血液在多次连续注射十二氟戊烷后如何保持稳定。然而，在每隔10分钟注射8次的狗中，肺动脉压和肺血管阻力显著增加，动脉氧饱和度和心输出量下降。使用静脉注射十二氟戊烷的心肌超声造影准确地确定了心肌危险区域和梗死面积。每隔30分钟注射四次十二氟戊烷，血流动力学变量和局部心肌血流保持稳定；更频繁的给药会导致心肺功能恶化。十二氟戊烷为治疗干预后再灌注的可靠、无创评估提供了潜力。
Objectives. This study assessed the accuracy of 2% dodecafluoropentane (EchoGen), an intravenous echocardiographic contrast agent, in identifying myocardial area at risk and infarct size in the canine model of myocardial ischemia.Background. Myocardial contrast echocardiography allows determination of myocardial area at risk and infarct size but requires intracoronary injection in humans. The development of agents that can be delivered by peripheral intravenous injection could enable bedside myocardial contrast echocardiographic assessment of risk area, infarct size and reperfusion.Methods. Two protocols were used. Protocol 1 assessed the accuracy of myocardial contrast echocardiography using intravenous dodecafluoropentane in defining myocardial area at risk and infarct size in the canine model of regional myocardial ischemia versus gross pathologic specimens stained with monastral blue to determine area at risk and triphenyltetrazolium chloride to determine the area of necrosis. Protocol 2 assessed the effects of repeated injections of dodecafluoropentane (0.5 ml/kg body weight, four doses 30 min apart or eight doses 10 min apart) on myocardial blood flow and hemodynamic variables. Results. Myocardial contrast echocardiography accurately defined area at risk and infarct size (r = 0.96 vs. triphenyltetrazolium chloride). Myocardial blood how remained stable after multiple serial injections of dodecafluoropentane. However, a significant increase in pulmonary artery pressure and pulmonary vascular resistance, along with a decrease in arterial oxygen saturation and cardiac output, was seen in dogs that received eight injections at 10-min intervals,Conclusions. Myocardial contrast echocardiography using intravenous dodecafluoropentane accurately defined myocardial area at risk and infarct size. Hemodynamic variables and regional myocardial blood flows remained stable when dodecafluoropentane was injected at 30-min intervals for up to four doses; more frequent administration led to cardiopulmonary deterioration. Dodecafluoropentane offers the potential for reliable, noninvasive assessment of reperfusion after therapeutic interventions.