Effects of glycoprotein iib/iiia inhibition on microvascular flow after coronary reperfusion

Autor: Ori Ben-Yehuda, Hideki Kunichika, Stephane Lafitte, Barry Peters, Anthony N. DeMaria, Naomi Kunichika
Rok vydání: 2004
Předmět:
Zdroj: Journal of the American College of Cardiology. 43(2):276-283
ISSN: 0735-1097
DOI: 10.1016/j.jacc.2003.08.040
Popis: Objectives We assessed the effect of glycoprotein IIb/IIIa inhibition (GPI) on microvascular flow after coronary occlusion/reperfusion using quantitative myocardial contrast echocardiography (QMCE). Background Platelets may play a major role in the dissociation of epicardial artery recanalization and tissue-level reperfusion, referred to as the “no-reflow phenomenon.” Therefore, GPI might improve myocardial reperfusion, distinct from its effects on epicardial patency. Methods Three-hour occlusion of the left anterior descending coronary artery (LAD) was followed by 3-h reperfusion in 16 open-chest dogs: 8 controls and 8 given a continuous infusion of the GPI tirofiban, starting 45 min before LAD reopening. Perfusion of the LAD bed was quantified by the rate of intensity rise (b)by QMCE; myocardial blood flow (MBF) was assessed by fluorescent microspheres. Results No differences in bor MBF were observed within the risk area between the control and GPI groups at baseline or occlusion. However, band MBF were higher in GPI dogs than in controls during reperfusion, despite similar epicardial flow (p Conclusions As demonstrated by QMCE, GPI improves microvascular flow and reduces the infarct area after coronary occlusion/reperfusion, independent of epicardial flow. These data demonstrate the usefulness of QMCE in assessing microvascular flow, provide novel evidence for the role of platelets in the early phase of reperfusion injury, and show that GPI is of value in preserving microvascular perfusion after coronary reperfusion.
Databáze: OpenAIRE
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