Microvascular rheology of Definity microbubbles after intra-arterial and intravenous administration

Lindner, Jonathan R.; Song, Ji Sun; Jayaweera, Ananda R.; Sklenar, Jiri; Kaul, Sanjiv

doi:10.1067/mje.2002.117290

Cited by 250 publications

(179 citation statements)

References 12 publications

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“…This technique relies on the ultrasound detection of a microbubble contrast agent composed of a lipid shell and a perfluorocarbon gas core. These microbubbles average 4 m in diameter, remain entirely within the vascular space, and have similar rheology to erythrocytes (19). As a result, they are an excellent perfusion tracer.…”

mentioning

confidence: 95%

Microvascular Recruitment Is an Early Insulin Effect That Regulates Skeletal Muscle Glucose Uptake In Vivo

et al. 2004

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Insulin increases glucose disposal into muscle. In addition, in vivo insulin elicits distinct nitric oxide synthase-dependent vascular responses to increase total skeletal muscle blood flow and to recruit muscle capillaries (by relaxing resistance and terminal arterioles, respectively). In the current study, we compared the temporal sequence of vascular and metabolic responses to a 30-min physiological infusion of insulin (3 mU ⅐ min ؊1 ⅐ kg ؊1 , euglycemic clamp) or saline in rat skeletal muscle in vivo. We used contrast-enhanced ultrasound to continuously quantify microvascular volume. Insulin recruited microvasculature within 5-10 min (P < 0.05), and this preceded both activation of insulin-signaling pathways and increases in glucose disposal in muscle, as well as changes in total leg blood flow. Moreover, L-NAME (N -nitro-L-arginine-methyl ester), a specific inhibitor of nitric oxide synthase, blocked this early microvascular recruitment (P < 0.05) and at least partially inhibited early increases in muscle glucose uptake (P < 0.05). We conclude that insulin rapidly recruits skeletal muscle capillaries in vivo by a nitric oxidedependent action, and the increase in capillary recruitment may contribute to the subsequent glucose uptake.

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confidence: 95%

Microvascular Recruitment Is an Early Insulin Effect That Regulates Skeletal Muscle Glucose Uptake In Vivo

et al. 2004

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“…However, in an animal model, iv injection of perflutren lipid microspheres did not produce microvascular obstruction, largely because the microvascular rheology of these bubbles is similar to that of red blood cells. 23 In general, tissue retention and adherence to injured endothelium seems to be more characteristic of albumin-coated microbubbles than lipid-encapsulated microspheres. 24 An excellent safety profile has been generated for Definity™ in studies of patients with compromised vascular beds including coronary stenosis, 25 carotid stenosis, 26 and renal vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Case report: Optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography

Izrailtyan

Clark

Swaminathan

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: Perioperative pulmonary embolism (PE) is associated with significant morbidity and mortality. Intraoperatively, the clinical management of patients with PE can be enhanced by the use of transesophageal echocardiography (TEE) to visualize emboli, assess pulmonary artery (PA) anatomy, and monitor the function of the right ventricle. However, the sensitivity of intraoperative TEE to detect thromboemboli is reported to be below 50%. In this report, we describe the use of contrastenhanced TEE (CE-TEE) to improve the visualization of PE. Clinical features:A 44-yr-old female with chronic thromboembolic pulmonary hypertension was scheduled for pulmonary thromboendarterectomy. The precardiopulmonary bypass TEE exam demonstrated signs of PA obstruction and right ventricle dysfunction, but the borders of the thrombus in the right PA were only minimally visualized. Perflutren lipid microspheres, composed of octafluoropropane encapsulated in an outer lipid shell, were injected as a 0.3 mL iv bolus, while visualizing the right PA with harmonic ultrasound imaging. The CE-TEE image clearly visualized a large mobile thrombus along with a distinct pattern consistent with pulmonary flow obstruction. The postcardiopulmonary bypass CE-TEE confirmed thrombus evacuation and absence of PA flow abnormalities. Conclusion:Contrast-enhanced-TEE may decrease operator dependency and increase the sensitivity necessary to detect central, surgically accessible PE.

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“…Assessment of coronary physiology with MCE The rheology of microbubbles used for MCE is similar to that of red blood cells in microvasculature [18] and, thus, MCE is noninvasive and can accurately quantify myocardial blood flow velocity. At baseline, approximately 8 % of the left ventricular (LV) mass is constituted by blood present in the microcirculation, 90 % of which is in the capillaries [20,21].…”

Section: Physiology and Pathology Of Coronar Y Microcirculationmentioning

confidence: 99%

Quantitative Myocardial Contrast Echocardiography in Coronary Artery Disease

Ito

2006

J Echocardiogr

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SummaryIt is now possible to perform myocardial contrast echocardiography (MCE) at the bedside with intravenous injection of commercially available contrast media. Detecting coronary stenosis and myocardial viability in patients is the major aim of anMCE study, but its diagnosis has relied largely on subjective interpretation of regional perfusion by experienced readers. Thus, quantifying MCE data and displaying comprehensive images have been be necessary for its routine application. In this review, two methods for quantifying and displaying MCE parameters will be introduced: 1) parametric imaging that separately displays the parameters of myocardial blood volume, blood flow velocity, and myocardial blood flow; and 2) volumetric imaging that displays a color-coded map of myocardial blood volume fraction. Both methods of analysis provide quantitative and easy-to-understand images even to unexperienced observers. (J Echocardiogr 2006; 4: 99-109)

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Microvascular rheology of Definity microbubbles after intra-arterial and intravenous administration

Cited by 250 publications

References 12 publications

Microvascular Recruitment Is an Early Insulin Effect That Regulates Skeletal Muscle Glucose Uptake In Vivo

Microvascular Recruitment Is an Early Insulin Effect That Regulates Skeletal Muscle Glucose Uptake In Vivo

Case report: Optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography

Quantitative Myocardial Contrast Echocardiography in Coronary Artery Disease

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