Katayama, Yosuke and Ozawa, Koya and Negishi, Tomoko and Gerber, Robert and Negishi, Kazuaki (2026) Therapeutic ultrasound for acute myocardial infarction: Mechanisms, preclinical evidence, and clinical perspectives. Journal of Cardiology, 87 (5). pp.459-467. ISSN 09145087
Full text not available from this repository.Abstract
ST-segment elevation myocardial infarction remains a leading cause of mortality. Despite the success of primary percutaneous coronary intervention (PCI), outcomes have plateaued, largely due to reperfusion injury and subsequent microvascular obstruction. This review examines the evolving landscape of microbubble-enhanced ultrasound therapy (aka sonothrombolysis/ sonoperfusion), which is a novel strategy aimed at mitigating reperfusion injury and improving myocardial salvage. We summarize the fundamental mechanisms and critically appraise the clinical trial evidence, from early feasibility studies to pivotal randomized controlled trials. The clinical application of this therapy has progressed significantly. While early trials without microbubbles or with suboptimal ultrasound parameters yielded neutral or even negative results, recent studies have demonstrated clear benefits. A critical determinant of success has emerged: the timing of the intervention. Compelling evidence from recent randomized trials indicates that therapy initiated before PCI significantly improves myocardial salvage and reduces infarct size. In contrast, post-PCI application alone appears to offer limited therapeutic benefit once significant microvascular injury is established. Microbubble-enhanced ultrasound therapy, particularly when administered pre-PCI, represents a promising adjunctive treatment to address the persistent challenge of reperfusion injury. Its potential for pre-hospital application could make it a crucial bridging strategy, capable of initiating myocardial salvage at the earliest possible moment. Further research should focus on technological refinement and validating its efficacy in a pre-hospital setting.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 04 Sep 2026 05:49 |
| Last Modified: | 04 Sep 2026 05:49 |
| URI: | http://eprints.victorchang.edu.au/id/eprint/1834 |
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