Enhanced myocardial salvage by maintenance of microvascular patency following initial thrombolysis with recombinant tissue plasminogen activator
| Autor: | Alison J Ford, David J Longridge, Miles P Maxwell, Michael J Follenfant, Bernadette Hughes |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Physiology medicine.medical_treatment Myocardial Infarction Ischemia Myocardial Reperfusion Anterior Descending Coronary Artery Dogs Reperfusion therapy Coronary Circulation Physiology (medical) Infusion Procedure Internal medicine medicine Animals Thrombolytic Therapy Thrombus Infusions Intravenous Saline Vascular Patency business.industry Microcirculation Fibrinogen Thrombolysis medicine.disease Recombinant Proteins Disease Models Animal Tissue Plasminogen Activator Cardiology Female Partial Thromboplastin Time Cardiology and Cardiovascular Medicine business Fibrinolytic agent |
| Zdroj: | Cardiovascular Research. 24:697-706 |
| ISSN: | 0008-6363 |
| DOI: | 10.1093/cvr/24.9.697 |
| Popis: | Study objective – The aim was to examine the value of a subthrombolytic maintenance infusion of recombinant double chain tissue plasminogen activator (BW t-PA, Duteplase) in preserving microvascular coronary flow following initial thrombolysis. Design – Coronary arterial thrombi were induced by a copper coil (placed under fluoroscopic control) in the canine left anterior descending coronary artery. Complete vessel occlusion occurred within 10–15 min of coil placement. Following 90 min of thrombotic occlusion, animals received one of three treatments: group 1, vehicle 0.9% saline; group 2, t-PA 1.0 × 106 IU·kg−1·h−1 for 1 h; group 3, t-PA l.0 × 106 IU·kg−1·h−1 for 1 h followed by 0.12 × 106 IU·kg−1·h−1 throughout the 2 h reperfusion period. Radiolabelled microspheres were administered to assess microvascular coronary flow at various time points throughout the experimental period. Subjects – Experimental subjects were beagle dogs of either sex (n = 30), weight 8.9-14.3 kg. Measurements and main results – Main vessel patency (assessed fluoroscopically) was achieved within 40.0(SEM 4.0) min and 37.0(3.1) min for group 2 and group 3 animals respectively. Group 1 animals did not reperfuse. Full microvascular coronary flow was achieved following the lytic infusion of t-PA. However, microvascular flow to the ischaemic zone was significantly reduced at the end of the 2 h reperfusion phase in group 2 animals despite ‘aggressive’ anticoagulation with heparin throughout the reperfusion period: subendocardial flow decreased from 0.74(0.14) to 0.24(0.08) ml·min−1·g−1; subepicardial flow decreased from 0.82(0.13) to 0.36(0.09) ml·min−1·g−1, p |
| Databáze: | OpenAIRE |
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