Albumin microbubble persistence during myocardial contrast echocardiography is associated with microvascular endothelial glycocalyx damage

Jonathan R. Lindner, Suad Ismail, William D. Spotnitz, Danny M. Skyba, Ananda R. Jayaweera, Sanjiv Kaul

    Research output: Contribution to journalArticle

    78 Scopus citations

    Abstract

    Background - We hypothesized that the persistence of albumin microbubbles within the myocardium during crystalloid cardioplegia (CP) infusion and ischemia-reperfusion (I-R) occurs because of endothelial injury. Methods and Results - The myocardial transit rate of albumin microbubbles was measured in 18 dogs perfused with different CP solutions and in 12 dogs undergoing I-R. Electron microscopy with cationized ferritin labeling of the glycocalyx was performed in 9 additional dogs after CP perfusion and in 3 additional dogs undergoing I-R. Microbubble transit was markedly prolonged during crystalloid CP perfusion. The addition of whole blood to the CP solution accelerated the transit rate in a dose-dependent fashion (P<0.05), which was greater with venous than with arterial blood (P<0.05). The addition of plasma or red blood cells to CP solutions was less effective in improving transit rate than addition of whole blood (P<0.05). Microbubble transit rate was independent of the temperature, K+ content, pH, PO2, osmolality, viscosity, and flow rate of the perfusate. Similarly, a proportion of microbubbles persisted in the myocardium after I-R, which was related to the duration of ischemia (P<0.01) but not of reflow. Crystalloid CP perfusion and I-R resulted in extensive loss of the endothelial glycocalyx without other ultrastructural changes. This effect was partially reversed in the case of crystalloid CP when it was followed by blood CP. Conclusions - Sonicated albumin microbubbles persist within the myocardium in situations in which the endothelial glycocalyx is damaged. The measurement of the myocardial transit rate of albumin microbubbles may provide an in vivo assessment of endothelial glycocalyx damage.

    Original languageEnglish (US)
    Pages (from-to)2187-2194
    Number of pages8
    JournalCirculation
    Volume98
    Issue number20
    DOIs
    StatePublished - Nov 17 1998

    Keywords

    • Echocardiography
    • Endothelium
    • Microspheres

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

    Fingerprint Dive into the research topics of 'Albumin microbubble persistence during myocardial contrast echocardiography is associated with microvascular endothelial glycocalyx damage'. Together they form a unique fingerprint.

  • Cite this