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Coronary microembolization causes long-term detrimental effects on regional left ventricular function.

Carlsson, Marcus LU ; Jablonowski, Robert; Martin, Alastair J; Ursell, Philip C and Saeed, Maythem (2011) In Scandinavian cardiovascular journal : SCJ 45. p.205-214
Abstract
Abstract Objectives. To investigate whether coronary microemboli have long-term effects on left ventricular (LV) function in an experimental model. Furthermore, to determine if first-pass perfusion and late gadolinium enhancement (LGE) patterns differs between small- and large-sized microemboli. Design. Six pigs underwent left anterior descending (LAD)-coronary microembolization with small-sized (40-120 μm, n∼250 000) microemboli using a combined x-ray and MRI-system. MR-images before, one hour after and 7-8 weeks after microembolization were obtained. Results were compared to MRI obtained by large-sized (100-300 μm, n∼7200) microemboli. Results. Cine MRI showed an acute drop in ejection fraction (from 49.5 ± 2.6% to 32.5 ± 2.8) that... (More)
Abstract Objectives. To investigate whether coronary microemboli have long-term effects on left ventricular (LV) function in an experimental model. Furthermore, to determine if first-pass perfusion and late gadolinium enhancement (LGE) patterns differs between small- and large-sized microemboli. Design. Six pigs underwent left anterior descending (LAD)-coronary microembolization with small-sized (40-120 μm, n∼250 000) microemboli using a combined x-ray and MRI-system. MR-images before, one hour after and 7-8 weeks after microembolization were obtained. Results were compared to MRI obtained by large-sized (100-300 μm, n∼7200) microemboli. Results. Cine MRI showed an acute drop in ejection fraction (from 49.5 ± 2.6% to 32.5 ± 2.8) that substantially recovered at 7-8 weeks (47.5 ± 3.2%). Regional LV-function assessed as circumferential, longitudinal and radial strain declined in both microinfarcts and remote regions followed by partial recovery at 7-8 weeks. The decline in LV function and the severe perfusion deficit from the small microemboli was similar to the large microemboli at one hour. There was a significant recovery in perfusion at 7-8 weeks in the microinfarcts. LGE demonstrated the microinfarcts at 7-8 weeks but not at one hour and the microinfarcts were confirmed by histopathology. Conclusion. Microembolization causes long-term, regional LV dysfunction and this study confirmed the need of a comprehensive MRI-protocol for the detection of microinfarcts. These findings suggest that even small microemboli (40-120 μm in diameter), which may escape the distal protective devices influence cardiac function. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian cardiovascular journal : SCJ
volume
45
pages
205 - 214
publisher
Taylor & Francis
external identifiers
  • WOS:000292919500003
  • PMID:21463182
  • Scopus:79960726360
ISSN
1651-2006
DOI
10.3109/14017431.2011.568629
language
English
LU publication?
yes
id
61abd6df-ec33-4fbe-98b4-99b55271ac35 (old id 1937529)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21463182?dopt=Abstract
date added to LUP
2011-05-02 09:39:52
date last changed
2016-11-08 14:10:28
@misc{61abd6df-ec33-4fbe-98b4-99b55271ac35,
  abstract     = {Abstract Objectives. To investigate whether coronary microemboli have long-term effects on left ventricular (LV) function in an experimental model. Furthermore, to determine if first-pass perfusion and late gadolinium enhancement (LGE) patterns differs between small- and large-sized microemboli. Design. Six pigs underwent left anterior descending (LAD)-coronary microembolization with small-sized (40-120 μm, n∼250 000) microemboli using a combined x-ray and MRI-system. MR-images before, one hour after and 7-8 weeks after microembolization were obtained. Results were compared to MRI obtained by large-sized (100-300 μm, n∼7200) microemboli. Results. Cine MRI showed an acute drop in ejection fraction (from 49.5 ± 2.6% to 32.5 ± 2.8) that substantially recovered at 7-8 weeks (47.5 ± 3.2%). Regional LV-function assessed as circumferential, longitudinal and radial strain declined in both microinfarcts and remote regions followed by partial recovery at 7-8 weeks. The decline in LV function and the severe perfusion deficit from the small microemboli was similar to the large microemboli at one hour. There was a significant recovery in perfusion at 7-8 weeks in the microinfarcts. LGE demonstrated the microinfarcts at 7-8 weeks but not at one hour and the microinfarcts were confirmed by histopathology. Conclusion. Microembolization causes long-term, regional LV dysfunction and this study confirmed the need of a comprehensive MRI-protocol for the detection of microinfarcts. These findings suggest that even small microemboli (40-120 μm in diameter), which may escape the distal protective devices influence cardiac function.},
  author       = {Carlsson, Marcus and Jablonowski, Robert and Martin, Alastair J and Ursell, Philip C and Saeed, Maythem},
  issn         = {1651-2006},
  language     = {eng},
  pages        = {205--214},
  publisher    = {ARRAY(0xac14a70)},
  series       = {Scandinavian cardiovascular journal : SCJ},
  title        = {Coronary microembolization causes long-term detrimental effects on regional left ventricular function.},
  url          = {http://dx.doi.org/10.3109/14017431.2011.568629},
  volume       = {45},
  year         = {2011},
}