Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Mathias, Wilson; Tsutsui, Jeane Mike; Tavares, Bruno Garcia; Fava, Agostina M.; Aguiar, Miguel; Borges, Bruno C.; Oliveira, Múcio Tavares de; Soeiro, Alexandre de Matos; Nicolau, José Carlos; Ribeiro, Henrique Barbosa; Chiang, Hsu Po; Sbano, João; Morad, Abdulrahman; Goldsweig, Andrew M.; Rochitte, Carlos Eduardo; Lopes, Bernardo B.C.; Ramírez, José A.; Filho, Roberto Kalil; Porter, Thomas R.; Investigators, Mrusmi

doi:10.1016/j.jacc.2019.03.006

Cited by 82 publications

(51 citation statements)

References 32 publications

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“…Low acoustic energy ultrasound with shorter pulse duration is generally used to diagnose myocardial perfusion and wall motion criteria [ 15 ]. The results of the study were consistent with the results of a single-blind randomized trial [ 3 ], randomized clinical studies [ 8 , 16 ], experimental model studies [ 7 , 17 ], and CLOTBUST trial [ 9 ]. Diagnostic ultrasound with longer pulse duration before and after percutaneous coronary interventions prevents microvascular coronary obstructions and its complications [ 3 ] because high acoustic energy ultrasound cause microbubbles to cavitate during the period of insonation [ 7 ] which creates shear stress and dissolves thrombus [ 17 ].…”

Section: Discussionsupporting

confidence: 82%

“…In these patients’ ultrasound enhancing agents were administered and two different imaging techniques were applied. To our knowledge there has been only 1 randomized clinical trial with less patients related to contrast-ultrasound treatment of patients with ST elevation myocardial infarction [ 3 , 16 ]. The results in the current study could become important to further promote sonothrombolysis in patients with myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

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High versus Low Mechanical Index Imaging Diagnostic Ultrasound in Patients with Myocardial Infarction: A Therapeutic Application Study

Niu

Zhang

et al. 2020

Med Sci Monit

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Background High mechanical index impulse of ultrasound is used for diagnosis of microvascular coronary obstruction and the necrotic area, but an experimental model study suggested that it can restore microvascular and epicardial coronary flow. The purposes of the study were to test the safety and therapeutic efficacy of high acoustic energy diagnostic ultrasound in patients with ST-segment elevation myocardial infarction. Material/Methods Patients with ST-segment elevation myocardial infarction subjected to a low (n=199) or high (n=251) mechanical index ultrasound before and after percutaneous coronary interventions and echocardiographic parameters were evaluated. Coronary angiographies were performed for the assessment of culprit vessels. Thrombolysis in myocardial infarction flow grade 1 or 2 were considered as culprit vessels. Results Patients diagnosed through low acoustic energy ultrasound reported 235 infarct vessels and patients diagnosed through high acoustic energy ultrasound reported 300 infarct vessels. With respect to low acoustic energy, high acoustic energy reduced the number of culprit vessels at post-percutaneous coronary interventions at 48 hours before hospital discharge ( P =0.015) and post-percutaneous coronary interventions at 1-month from the baseline interventions ( P =0.043). Also, the maximum% ST-segment resolution and an ejection fraction of the left ventricle was increased and microvascular coronary obstruction in infarct vessels was decreased for both evaluation points. High acoustic energy could not affect heart rate ( P =0.133) and oxygen saturation ( P =0.079). Conclusions High acoustic energy ultrasound is a safe method for diagnosis of ST-segment elevation myocardial infarction and may have therapeutic applications.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

High versus Low Mechanical Index Imaging Diagnostic Ultrasound in Patients with Myocardial Infarction: A Therapeutic Application Study

Niu

Zhang

et al. 2020

Med Sci Monit

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“… 6 , 7 The mechanism for sono-thrombolysis appears to be cavitation induced thrombus dissolution in addition to vasodilation induced by endothelial shear-release of nitric oxide. 8 …”

Section: Catheter-based Drug Deliverymentioning

confidence: 99%

“…It should be noted that while there has been substantial research on local drug delivery vehicles in cancer and cardiovascular medicine, broadly; there appear to be only a handful of reports that describes using different carriers for targeted delivery in patients with COVID-19. 6 – 10 In the following, some of the newer approaches for targeted drug delivery in COVID-19 patients are discussed. It may also apply to other bacterial or viral pneumonias not associated with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Targeted, Site-Specific, Delivery Vehicles of Therapeutics for COVID-19 Patients. Brief Review

Kipshidze

Iversen

Porter

et al. 2020

Clin Appl Thromb Hemost

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Definitive pharmacological therapies for COVID-19 have yet to be identified. Several hundred trials are ongoing globally in the hope of a solution. However, nearly all treatments rely on systemic delivery but COVID-19 damages the lungs preferentially. The use of a targeted delivery approach is reviewed where engineered products are able to reach damaged lung tissue directly, which includes catheter-based and aerosol-based approaches. In this review we have outlined various target directed approaches which include microbubbles, extracellular vesicles including exosomes, adenosine nanoparticles, novel bio-objects, direct aerosol targeted pulmonary delivery and catheter-based drug delivery with reference to their relative effectiveness for the specific lesions. Currently several trials are ongoing to determine the effectiveness of such delivery systems alone and in conjunction with systemic therapies. Such approaches may prove to be very effective in the controlled and localized COVID-19 viral lesions in the lungs and potential sites. Moreover, localized delivery offered a safer delivery mode for such drugs which may have systemic adverse effects.

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“…Os achados foram confirmados no estudo atual, ampliando a população para 100 pacientes. Os estudos iniciais de sonotrombólise em humanos44,52 demonstraram que as taxas precoces de recanalização epicárdica foram significativamente maiores com a aplicação breve e intermitente de impulsos de alto IM na microcirculação pelas janelas apicais. Esses efeitos benéficos foram evidentes a nível microvascular, com melhora do fluxo capilar já observada imediatamente após a intervenção coronária percutânea.…”

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Uso terapêutico de ultrassom e microbolhas na recanalização de infarto agudo do miocárdio

Tavares¹

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Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Cited by 82 publications

References 32 publications

High versus Low Mechanical Index Imaging Diagnostic Ultrasound in Patients with Myocardial Infarction: A Therapeutic Application Study

High versus Low Mechanical Index Imaging Diagnostic Ultrasound in Patients with Myocardial Infarction: A Therapeutic Application Study

Targeted, Site-Specific, Delivery Vehicles of Therapeutics for COVID-19 Patients. Brief Review

Uso terapêutico de ultrassom e microbolhas na recanalização de infarto agudo do miocárdio

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