Sonothrombolysis Promotes Improvement in Left Ventricular Wall Motion and Perfusion Scores after Acute Myocardial Infarction

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTAVARES, Bruno G.
dc.contributor.authorAGUIAR, Miguel Osman
dc.contributor.authorTSUTSUI, Jeane
dc.contributor.authorOLIVEIRA, Mucio
dc.contributor.authorSOEIRO, Alexandre de Matos
dc.contributor.authorNICOLAU, Jose
dc.contributor.authorRIBEIRO, Henrique
dc.contributor.authorPOCHIANG, Hsu
dc.contributor.authorSBANO, Joao
dc.contributor.authorROCHITTE, Carlos Eduardo
dc.contributor.authorLOPES, Bernardo
dc.contributor.authorRAMIREZ, Jose
dc.contributor.authorKALIL FILHO, Roberto
dc.contributor.authorMATHIAS, Wilson
dc.date.accessioned2022-08-12T17:05:48Z
dc.date.available2022-08-12T17:05:48Z
dc.date.issued2022
dc.description.abstractBackground: It has recently been demonstrated that the application of high-energy ultrasound and microbubbles, in a technique known as sonothrombolysis, dissolves intravascular thrombi and increases the angiographic recanalization rate in patients with ST-segment-elevation myocardial infarction (STEMI). Objective: To evaluate the effects of sonothrombolysis on left ventricular wall motion and myocardial perfusion in patients with STEMI, using real-time myocardial perfusion echocardiography (RTMPE). Methods: One hundred patients with STEMI were randomized into the following 2 groups: therapy (50 patients treated with sonothrombolysis and primary coronary angioplasty) and control (50 patients treated with primary coronary angioplasty). The patients underwent RTMPE for analysis of left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and number of segments with myocardial perfusion defects 72 hours after STEMI and at 6 months of follow-up. P < 0.05 was considered statistically significant. Results: Patients treated with sonothrombolysis had higher LVEF than the control group at 72 hours (50% +/- 10% versus 44% +/- 10%; p = 0.006), and this difference was maintained at 6 months of follow-up (53% +/- 10% versus 48% +/- 12%; p = 0.008). The WMSI was similar in the therapy and control groups at 72 hours (1.62 +/- 0.39 versus 1.75 +/- 0.40; p = 0.09), but it was lower in the therapy group at 6 months (1.46 +/- 0.36 versus 1.64 +/- 0.44; p = 0.02). The number of segments with perfusion defects on RTMPE was similar in therapy and control group at 72 hours (5.92 +/- 3.47 versus 6.94 +/- 3.39; p = 0.15), but it was lower in the therapy group at 6 months (4.64 +/- 3.31 versus 6.57 +/- 4.29; p = 0.01). Conclusion: Sonothrombolysis in patients with STEMI resulted in improved wall motion and ventricular perfusion scores over time.eng
dc.description.abstractFundamento: Demonstrou-se recentemente que a aplicação de ultrassom de alta energia com microbolhas, técnica conhecida como sonotrombólise, causa a dissolução de trombos intravasculares e aumenta a taxa de recanalização angiográfica no infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAM-CSST). Objetivo: Avaliar o efeito da sonotrombólise nos índices de motilidade e perfusão miocárdicas em pacientes com IAM-CSST, utilizando a ecocardiografia com perfusão miocárdica em tempo real (EPMTR). Método: Uma centena de pacientes com IAM-CSST foram randomizados em dois grupos: Terapia (50 pacientes tratados com sonotrombólise e angioplastia coronária primária) e Controle (50 pacientes tratados com angioplastia coronária primária). Os pacientes realizaram EPMTR para analisar a fração de ejeção do ventrículo esquerdo (FEVE), o índice de escore de motilidade segmentar (IEMS) e o número de segmentos com defeito de perfusão miocárdica, 72 horas após o IAM-CSST e com 6 meses de acompanhamento. Foi considerado significativo p < 0,05. Resultados: Pacientes tratados com sonotrombólise apresentaram FEVE mais alta que o grupo Controle em 72 horas (50 ± 10% vs. 44 ± 10%; p = 0,006), e essa melhora foi mantida em seis meses (53 ± 10% vs. 48 ± 12%; p = 0,008). O IEMS foi similar nos grupos Terapia e Controle em 72 horas (1,62 ± 0,39 vs. 1,75 ± 0,40; p = 0,09), mas tornou-se menor no grupo Terapia em 6 meses (1,46 ± 0,36 vs. 1,64 ± 0,44; p = 0,02). O número de segmentos com defeito de perfusão não foi diferente entre os grupos em 72 horas (5,92 ± 3,47 vs. 6,94 ± 3,39; p = 0,15), mas ficou menor no grupo Terapia em 6 meses (4,64 ± 3,31 vs. 6,57 ± 4,29; p = 0,01). Conclusão: A sonotrombólise em pacientes com IAM-CSST resulta na melhora dos índices de motilidade e perfusão ventricular ao longo do tempo.
dc.description.indexMEDLINEeng
dc.identifier.citationARQUIVOS BRASILEIROS DE CARDIOLOGIA, v.118, n.4, p.756-765, 2022
dc.identifier.doi10.36660/abc.20200651
dc.identifier.issn0066-782X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/48335
dc.language.isopor
dc.publisherARQUIVOS BRASILEIROS CARDIOLOGIAeng
dc.relation.ispartofArquivos Brasileiros de Cardiologia
dc.rightsopenAccesseng
dc.rights.holderCopyright ARQUIVOS BRASILEIROS CARDIOLOGIAeng
dc.subjectMyocardial Infarctioneng
dc.subjectSonothrombolysiseng
dc.subjectMicrobubbleseng
dc.subjectContrast Mediaeng
dc.subjectVentricular Function Lefteng
dc.subjectPulmonary Embolismeng
dc.subjectInfarto do Miocárdio
dc.subjectSonotrombólise
dc.subjectMicrobolhas
dc.subjectMeios de Contraste
dc.subjectFunção Ventricular Esquerda
dc.subjectEmbolia Pulmonar
dc.subject.otherdiagnostic ultrasoundeng
dc.subject.othertranscutaneous ultrasoundeng
dc.subject.othercavitational mechanismseng
dc.subject.otheramerican societyeng
dc.subject.otherthrombolysiseng
dc.subject.othercoronaryeng
dc.subject.otherechocardiographyeng
dc.subject.othermicrobubbleseng
dc.subject.otherhearteng
dc.subject.otherfeasibilityeng
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.titleSonothrombolysis Promotes Improvement in Left Ventricular Wall Motion and Perfusion Scores after Acute Myocardial Infarctioneng
dc.title.alternativeA Sonotrombólise Promove Melhora dos Índices de Motilidade e Perfusão do Ventrículo Esquerdo após o Infarto Agudo do Miocárdio
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalAGUIAR, Miguel Osman:Univ Sao Paulo, Fac Med, Hosp Clin, Inst Coracao, Rua Fidalga 618,Apt 84, BR-05303000 Sao Paulo, SP, Brazil
hcfmusp.author.externalLOPES, Bernardo:Univ Sao Paulo, Fac Med, Hosp Clin, Inst Coracao, Rua Fidalga 618,Apt 84, BR-05303000 Sao Paulo, SP, Brazil
hcfmusp.author.externalRAMIREZ, Jose:Univ Sao Paulo, Fac Med, Hosp Clin, Inst Coracao, Rua Fidalga 618,Apt 84, BR-05303000 Sao Paulo, SP, Brazil
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcBRUNO GARCIA TAVARES
hcfmusp.contributor.author-fmusphcJEANE MIKE TSUTSUI
hcfmusp.contributor.author-fmusphcMUCIO TAVARES DE OLIVEIRA JUNIOR
hcfmusp.contributor.author-fmusphcALEXANDRE DE MATOS SOEIRO
hcfmusp.contributor.author-fmusphcJOSE CARLOS NICOLAU
hcfmusp.contributor.author-fmusphcHENRIQUE BARBOSA RIBEIRO
hcfmusp.contributor.author-fmusphcHSU PO CHIANG
hcfmusp.contributor.author-fmusphcJOAO CESAR NUNES SBANO
hcfmusp.contributor.author-fmusphcCARLOS EDUARDO ROCHITTE
hcfmusp.contributor.author-fmusphcROBERTO KALIL FILHO
hcfmusp.contributor.author-fmusphcWILSON MATHIAS JUNIOR
hcfmusp.description.beginpage756
hcfmusp.description.endpage765
hcfmusp.description.issue4
hcfmusp.description.volume118
hcfmusp.origemWOS
hcfmusp.origem.pubmed35508053
hcfmusp.origem.scieloSCIELO:S0066-782X2022000400756
hcfmusp.origem.scopus2-s2.0-85129384147
hcfmusp.origem.wosWOS:000813888900019
hcfmusp.publisher.cityRIO DE JANEIROeng
hcfmusp.publisher.countryBRAZILeng
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