Value of adenosine infusion for infarct size determination using real-time myocardial contrast echocardiography

BACKGROUND: Myocardial contrast echocardiography has been used for determination of infarct size (IS) in experimental models. However, with intermittent harmonic imaging, IS seems to be underestimated immediately after reperfusion due to areas with preserved, yet dysfunctional, microvasculature. The use of exogenous vasodilators showed to be useful to unmask these infarcted areas with depressed coronary flow reserve. This study was undertaken to assess the value of adenosine for IS determination in an open-chest canine model of coronary occlusion and reperfusion, using real-time myocardial contrast echocardiography (RTMCE). METHODS: Nine dogs underwent 180 minutes of coronary occlusion followed by reperfusion. PESDA (Perfluorocarbon-Exposed Sonicated Dextrose Albumin) was used as contrast agent. IS was determined by RTMCE before and during adenosine infusion at a rate of 140 mcg·Kg(-1)·min(-1). Post-mortem necrotic area was determined by triphenyl-tetrazolium chloride (TTC) staining. RESULTS: IS determined by RTMCE was 1.98 ± 1.30 cm(2 )and increased to 2.58 ± 1.53 cm(2 )during adenosine infusion (p = 0.004), with good correlation between measurements (r = 0.91; p < 0.01). The necrotic area determined by TTC was 2.29 ± 1.36 cm(2 )and showed no significant difference with IS determined by RTMCE before or during hyperemia. A slight better correlation between RTMCE and TTC measurements was observed during adenosine (r = 0.99; p < 0.001) then before it (r = 0.92; p = 0.0013). CONCLUSION: RTMCE can accurately determine IS in immediate period after acute myocardial infarction. Adenosine infusion results in a slight better detection of actual size of myocardial damage

Multiscale analysis of materials with anisotropic microstructure as micropolar continua

Multiscale procedures are often adopted for the continuum modeling of materials composed of a specific micro-structure. Generally, in mechanics of materials only two-scales are linked. In this work the original (fine) micro-scale description, thought as a composite material made of matrix and fibers/particles/crystals which can interact among them, and a scale-dependent continuum (coarse) macro-scale are linked via an energy equivalence criterion. In particular the multiscale strategy is proposed for deriving the constitutive relations of anisotropic composites with periodic microstructure and allows us to reduce the typically high computational cost of fully microscopic numerical analyses. At the microscopic level the material is described as a lattice system while at the macroscopic level the continuum is a micropolar continuum, whose material particles are endowed with orientation besides position. The derived constitutive relations account for shape, texture and orientation of inclusions as well as internal scale parameters, which account for size effects even in the elastic regime in the presence of geometrical and/or load singularities. Applications of this procedure concern polycrystals, wherein an important descriptor of the underlying microstructure gives the orientation of the crystal lattice of each grain, fiber reinforced composites, as well as masonry-like materials. In order to investigate the effects of micropolar constants in the presence of material non central symmetries, some numerical finite element simulations, with elements specifically formulated for micropolar media, are presented. The performed simulations, which extend several parametric analyses earlier performed [1], involve two-dimensional media, in the linear framework, subjected to compression loads distributed in a small portion of the medium