title: Relationship between retrograde coronary blood flow and the extent of no-reflow and infarct size in a porcine ischemia-reperfusion model.
abstract: Recanalization of an infarct-related artery does not predictably reflect tissue reperfusion. We examined the relationship between coronary blood flow (CBF) pattern during reperfusion and infarcted (IA) and no-reflow (NR) area in a porcine ischemia-reperfusion model. The mid-left anterior descending artery of 18 pigs was occluded for 1 h and reperfused for 2 h. CBF during reperfusion was measured with a transit-time ultrasound flowmeter, while systemic arterial and left atrial pressures were monitored. IA and NR were measured with triphenyl tetrazolium chloride and thioflavin staining, respectively. In 13 pigs, early systolic retrograde CBF developed within the first 30 min and persisted throughout reperfusion. No retrograde CBF was observed in five pigs. Mean retrograde CBF at 2 h of reperfusion predicted a larger IA (r = 0.71; p = 0.001). Time-to-development of retrograde CBF was inversely related to IA (r = -0.55; p = 0.019) and NR (r = -0.62; p = 0.006). A larger IA (OR 1.12, 95% CI 1.01-1.24, p = 0.037) and NR (OR 1.09, 95% CI 1.01-1.18, p = 0.037) predicted the presence of retrograde CBF. Retrograde CBF during recanalization of the infarct-related artery predicts IA and NR and might be used as an index of successful reperfusion at the tissue level.
authors.affiliation: Department of Clinical Therapeutics, University of Athens School of Medicine Alexandra Hospital, Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Stavrakis
authors.forename: John
authors.initials: J
authors.lastname: Terrovitis
authors.forename: Elias
authors.initials: E
authors.lastname: Tsolakis
authors.forename: Stavros
authors.initials: S
authors.lastname: Drakos
authors.forename: Argirios
authors.initials: A
authors.lastname: Dalianis
authors.forename: Michael
authors.initials: M
authors.lastname: Bonios
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Koudoumas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Malliaras
authors.forename: John
authors.initials: J
authors.lastname: Nanas
mesh_terms: D000818:Animals; D016279:Atrial Function, Left; D001783:Blood Flow Velocity; D001794:Blood Pressure; D003326:Coronary Circulation; D004195:Disease Models, Animal; D006339:Heart Rate; D017078:Laser-Doppler Flowmetry; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D013552:Swine; D013997:Time Factors; D014463:Ultrasonography