The clinical implications of no reflow demonstrated with intravenous perfluorocarbon containing microbubbles following restoration of thrombolysis in myocardial infarction (TIMI) 3 flow in patients with acute myocardial infarction

Thomas Richard Porter, Shouping Li, Rebecca Oster, Ubeydullah Deligonul

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118 Citations (Scopus)

Abstract

Intravenous injections or infusions of perfluorocarbon-exposed sonicated dextrose albumin microbubbles were given 2.4 ± 1.6 days following acute myocardial infarction to 45 consecutive patients. Patients were divided into 3 groups: patients with Thrombolysis In Myocardial Infarction (TIMI) grade 3 angiographic flow but persistent myocardial contrast defects by echocardiography (no reflow), patients with TIMI 3 flow and myocardial contrast enhancement (reflow), and patients with TIMI grade 0 to 2 flow in the infarct vessel. Thirty-five patients had TIMI 3 flow at the time of contrast study. Of these, 25 had evidence of reflow with intravenous contrast, whereas 10 (29%) still had contrast defects. At follow-up, end- systolic volume index decreased significantly in patients who exhibited reflow (21 ± 8 ml/m2 at baseline to 18 ± 8 ml/m2 at follow-up; p = 0.04), whereas those with no reflow had a significant increase (26 ± 9 ml/m2 at baseline to 32 ± 9 ml/m2 at follow-up; p = 0.006). A persistent contrast defect in the infarct zone demonstrated with intravenous ultrasound contrast following restoration of TIMI grade 3 flow in the infarct vessel identified patients likely to have deterioration in both regional and global systolic function.

Original languageEnglish (US)
Pages (from-to)1173-1177
Number of pages5
JournalAmerican Journal of Cardiology
Volume82
Issue number10
DOIs
StatePublished - Nov 15 1998

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Fluorocarbons
Microbubbles
Myocardial Infarction
Intravenous Infusions
Intravenous Injections
Echocardiography
Albumins
Glucose

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "The clinical implications of no reflow demonstrated with intravenous perfluorocarbon containing microbubbles following restoration of thrombolysis in myocardial infarction (TIMI) 3 flow in patients with acute myocardial infarction",
abstract = "Intravenous injections or infusions of perfluorocarbon-exposed sonicated dextrose albumin microbubbles were given 2.4 ± 1.6 days following acute myocardial infarction to 45 consecutive patients. Patients were divided into 3 groups: patients with Thrombolysis In Myocardial Infarction (TIMI) grade 3 angiographic flow but persistent myocardial contrast defects by echocardiography (no reflow), patients with TIMI 3 flow and myocardial contrast enhancement (reflow), and patients with TIMI grade 0 to 2 flow in the infarct vessel. Thirty-five patients had TIMI 3 flow at the time of contrast study. Of these, 25 had evidence of reflow with intravenous contrast, whereas 10 (29{\%}) still had contrast defects. At follow-up, end- systolic volume index decreased significantly in patients who exhibited reflow (21 ± 8 ml/m2 at baseline to 18 ± 8 ml/m2 at follow-up; p = 0.04), whereas those with no reflow had a significant increase (26 ± 9 ml/m2 at baseline to 32 ± 9 ml/m2 at follow-up; p = 0.006). A persistent contrast defect in the infarct zone demonstrated with intravenous ultrasound contrast following restoration of TIMI grade 3 flow in the infarct vessel identified patients likely to have deterioration in both regional and global systolic function.",
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