Diagnostic Ultrasound and Microbubbles Treatment Improves Outcomes of Coronary No-Reflow in Canine Models by Sonothrombolysis

作者：Hairui Li, Yongkang Lu, Yili Sun, Gangbin Chen, Junfen Wang, Shifei Wang, Chixiong Huang, Lintao Zhong, Xiaoyun Si, Wangjun Liao, Yulin Liao, Shiping Cao, Jianping Bin · 发表于：Critical Care Medicine · 年份：2018 · DOI：10.1097/ccm.0000000000003255 · 被引用次数：20 · 研究领域：Ultrasound and Hyperthermia Applications、Coronary Interventions and Diagnostics、Mechanical Circulatory Support Devices

OBJECTIVES: Effective treatment for microvascular thrombosis-induced coronary no-reflow remains an unmet clinical need. This study sought to evaluate whether diagnostic ultrasound and microbubbles treatment could improve outcomes of coronary no-reflow by dissolving platelet- and erythrocyte-rich microthrombi. DESIGN: Randomized controlled laboratory investigation. SETTING: Research laboratory. SUBJECTS: Mongrel dogs. INTERVENTIONS: Coronary no-reflow models induced by platelet- or erythrocyte-rich microthrombi were established and randomly assigned to control, ultrasound, recombinant tissue-type plasminogen activator, ultrasound + microbubbles, or ultrasound + microbubbles + recombinant tissue-type plasminogen activator group. All treatments lasted for 30 minutes. MEASUREMENTS AND MAIN RESULTS: Percentage of microemboli-obstructed coronary arterioles was lower in ultrasound + microbubbles group than that in control group for platelet- (> 50% obstruction: 10.20% ± 3.56% vs 31.80% ± 3.96%; < 50% obstruction: 14.80% ± 4.15% vs 28.20% ± 3.56%) and erythrocyte-rich microthrombi (> 50% obstruction: 8.20% ± 3.11% vs 30.60% ± 4.83%; < 50% obstruction: 12.80% ± 4.15% vs 25.80% ± 3.70%) (p < 0.001). Percentage change of myocardial blood flow in left anterior descending artery-dominated region, left ventricular ejection fraction, fractional shortening, and ST-segment resolution were higher, whereas infarcted area, troponin I, and creatine kinase MB isoenzyme were lower in ultrasound + m...