Magnitude and time course of microvascular obstruction and tissue injury after acute myocardial infarction
Magnitude and time course of microvascular obstruction and tissue injury after acute myocardial infarction
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DOI：
10.1161/01.cir.98.10.1006
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发表时间：
1998-09-08
期刊：
影响因子：
37.8
通讯作者：
Melin, JA
中科院分区：
文献类型：
--
作者：
Rochitte, CE;Lima, JAC;Melin, JA
背景-心肌梗死区域内的微血管阻塞提示功能恢复较差和梗死后并发症风险较高。在长时间的冠状动脉闭塞后，对比增强MRI可将心肌梗死识别为包含低增强核心的高增强区域。由于梗死/再灌注后的微血管阻塞的时间过程是未知的，我们检查微血管阻塞是否达到充分的程度后不久再灌注或显示显着的进展，在随后的2 days.Methods和Results-Seven狗进行了90分钟的球囊闭塞的左前降支冠状动脉（LAD），然后回流。在再灌注后2、6和48小时进行钆-DTPA增强MRT，并与放射性微球血流（MBF）测量和心肌染色进行比较，以确定微血管阻塞（硫磺素S）和梗死面积（氯化三苯基四氮唑，TTC）。再灌注后48小时内MRI低增强区增加3倍（2、6和48小时分别为左心室质量的3.2 ± 1.8%、6.7 ± 4.4%和9.9 ± 3.2%，P
Background-Microvascular obstruction within an area of myocardial infarction indicates worse functional recovery and a higher risk of postinfarction complications. After prolonged coronary occlusion, contrast-enhanced MRI identifies myocardial infarction as a hyperenhanced region containing a hypoenhanced core. Because the time course of microvascular obstruction after infarction/reperfusion is unknown, we examined whether microvascular obstruction reaches its full extent shortly after reperfusion or shows significant progression over the following 2 days.Methods and Results-Seven dogs underwent 90-minute balloon occlusion of the left anterior descending coronary artery (LAD) followed by reflow. Gadolinium-DTPA-enhanced MRT performed at 2, 6, and 48 hours after reperfusion was compared with radioactive microsphere blood flow (MBF) measurements and myocardial staining to define microvascular obstruction (thioflavin S) and infarct size (triphenyltetrazolium chloride, TTC). The MRI hypoenhanced region increased 3-fold during 48 hours after reperfusion (3.2+/-1.8%, 6.7+/-4.4%, and 9.9+/-3.2% of left ventricular mass at 2, 6, and 48 hours, respectively, P