High Ultrasound mechanical index and MicrobuBBLEs to reduce acute myocardial infarction burden I: Evaluation of left ventricular global longitudinal strain

• Grant number: 23/04572-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): May 01, 2023
• Effective date (End): April 30, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Wilson Mathias Júnior
• Grantee: Yasmin Abrahão
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated research grant: 18/06387-8 - High ultrasound mechanical index and microbubbles to reduce acute myocardial infarction burden I. HUBBLE-I study, AP.TEM

Abstract

Cardiovascular diseases are very prevalent around the world and have been suffering an increase in the past decades in Brazil, after the depletion of infectious diseases. Among those, acute coronary syndrome (ACS), besides being a prevalent diagnosis at the emergency service, represents an important cause of hospitalization, elevating the expenses of the healthcare system. Despite being an overly common situation, it is estimated that up to 60% of the patients do not have access to adequate treatment, such as fibrinolytics and percutaneous coronary intervention (PCI). In this scenario, sonothrombolysis emerges as an innovative therapy which represents low costs for the healthcare system and little risk for the patient, as well as having a great resolutive potential for diseases caused by acute thrombosis. The technique consists of a continuous infusion of microbubbles with the size of 1/3 of an erythrocyte that, when undergoing intermittent rupture by high energy ultrasound, can restore coronary microcirculation in ACS. Positive results of the effect of sonothrombolysis were already observed by Mathias et al., as increased rates of recanalization after PCI, reduction of infraction area and sustained improvement of the left ventricle systolic function. However, these benefits were studied exclusively in patients with acute ST-segment elevation myocardial infarction (STEMI). Hence, because of the intention to improve prognosis on a large spectrum of SCA and unstable angina, this study aims to evaluate the effect of this therapy in left ventricle function, in patients diagnosed with STEMI, Non-ST-Elevation Myocardial Infarction (NSTEMI) and high risk unstable angina treated with sonothrombolysis and PCI.