Contractile versus microvascular reserve for the determination of the extent of myocardial salvage after reperfusion

The effect of residual coronary stenosis

Jiri Sklenar, Gustavo Camarano, N. Craig Goodman, Suad Ismail, Ananda R. Jayaweera, Sanjiv Kaul

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: We hypothesized that microvascular reserve is a better indicator of the extent of viable myocardium postinfarction than contractile reserve, especially in the presence of the residual stenosis of the infarct- related artery. Methods and Results: Fifteen dogs with various infarct sizes were studied after reperfusion. Contractile reserve, studied by use of dobutamine echocardiography, and microvascular reserve, studied by use of myocardial echocardiography, were measured both before and after creation of a stenosis. In the absence of a stenosis, the relation between infarct size, expressed as percent of risk area, and wall thickening improved with increasing doses of dobutamine (r=.41, .71, and .90 for 5, 10, and 15 μg·kg -1·min -1, respectively; P- 1·min -1). In the presence of a stenosis, however, the relation was poor for all doses of dobutamine (r=.22, .57, and .32 for 5, 10, and 15 μg·kg - 1·min -1, respectively; P-1·min -1 dobutamine in the absence of a stenosis). There was fair correlation between infarct size and perfusion defect size on myocardial contrast echocardiography after reperfusion (r=.82), with the defect size underestimating infarct size by approximately 20%. This relationship improved (P

Original languageEnglish (US)
Pages (from-to)1430-1440
Number of pages11
JournalCirculation
Volume94
Issue number6
StatePublished - 1996
Externally publishedYes

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Coronary Stenosis
Dobutamine
Reperfusion
Pathologic Constriction
Echocardiography
Myocardium
Arteries
Perfusion
Dogs

Keywords

  • echocardiography
  • infarction
  • myocardium
  • stenosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Contractile versus microvascular reserve for the determination of the extent of myocardial salvage after reperfusion : The effect of residual coronary stenosis. / Sklenar, Jiri; Camarano, Gustavo; Goodman, N. Craig; Ismail, Suad; Jayaweera, Ananda R.; Kaul, Sanjiv.

In: Circulation, Vol. 94, No. 6, 1996, p. 1430-1440.

Research output: Contribution to journalArticle

Sklenar, Jiri ; Camarano, Gustavo ; Goodman, N. Craig ; Ismail, Suad ; Jayaweera, Ananda R. ; Kaul, Sanjiv. / Contractile versus microvascular reserve for the determination of the extent of myocardial salvage after reperfusion : The effect of residual coronary stenosis. In: Circulation. 1996 ; Vol. 94, No. 6. pp. 1430-1440.
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