Effects of glycoprotein iib/iiia inhibition on microvascular flow after coronary reperfusion
A quantitative myocardial contrast echocardiography study
Hideki Kunichika, MD, PhD*,
Ori Ben-Yehuda, MD, FACC*,
Stephane Lafitte, MD*,
Naomi Kunichika, MD, PhD*,
Barry Peters, MD* and
Anthony N. DeMaria, MD, MACC*,*
* Division of Cardiology, University of California at San Diego, San Diego, California, USA
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Figure 1 Time course of changes in the rate of intensity rise (b) parameter measurements by myocardial contrast echocardiography within the risk area at baseline, occlusion, and after coronary reperfusion for each control (n = 8) and glycoprotein IIb/IIIa inhibitor (GPI) (n = 8) group. *p < 0.05 versus control group at each stage. Data are expressed as the mean ± SD. R-30, R-60, R-90, and R-180 = reperfusion for 30, 60, 90, and 180 min, respectively.
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Figure 2 Representative end-systolic myocardial contrast echocardiography images by real-time imaging after high-energy fast low-angle shot (FLASH) transmission at 180-min reperfusion in both control and glycoprotein IIb/IIIa inhibitor (GPI) dogs. Arrows show an opacification defect after FLASH images. The defect size in the control group is larger than that in the GPI group.
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Figure 3 Correlation between the size of the infarct area by triphenyltetrazolium chloride (TTC) and that by myocardial contrast echocardiography (MCE) at 180-min reperfusion (control: n = 4; glycoprotein IIb/IIIa inhibitor [GPI]: n = 4). LV = left ventricle.
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Figure 4 Time course of changes in the myocardial blood flow within the risk area at baseline, occlusion, and after coronary reperfusion for the control (n = 8) and glycoprotein IIb/IIIa inhibitor (GPI) (n = 8) groups. *p < 0.05 versus control group at each stage. The data during occlusion and reperfusion are expressed as the mean percentage of baseline ± SD. R-30, R-60, R-90, and R-180 = reperfusion for 30, 60, 90, and 180 min, respectively.
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Figure 5 The relationship between infarct size at risk and mean myocardial blood flow (MBF) of risk area during coronary occlusion is illustrated for the control (n = 8) and glycoprotein IIb/IIIa inhibitor (GPI) (n = 8) groups. Each point represents an individual dog. A significant downward shift in the line of the inverse relationship was observed in the GPI-treated group (p < 0.05).
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