Advanced technique of myocardial no-reflow quantification using indocyanine green

Dmitry Sonin; Garry Papayan; Maria Istomina; Ilya Anufriev; Evgeniia Pochkaeva; Sarkis Minasian; Ekaterina Zaytseva; Daria Mukhametdinova; Daniil Mochalov; Ilia Aleksandrov; Nickolay Petrishchev; Michael Galagudza

doi:10.1364/BOE.511912

Advanced technique of myocardial no-reflow quantification using indocyanine green

Biomed Opt Express. 2024 Jan 17;15(2):818-833. doi: 10.1364/BOE.511912. eCollection 2024 Feb 1.

Authors

Dmitry Sonin^{1

2}, Garry Papayan^{1

2}, Maria Istomina^{1

3}, Ilya Anufriev^{1

3}, Evgeniia Pochkaeva⁴, Sarkis Minasian^{1

2}, Ekaterina Zaytseva¹, Daria Mukhametdinova¹, Daniil Mochalov¹, Ilia Aleksandrov¹, Nickolay Petrishchev², Michael Galagudza^{1

2}

Affiliations

¹ Institute of Experimental Medicine, Almazov National Medical Research Centre, 2 Akkuratova Str., 197341 Saint Petersburg, Russia.
² Pavlov First Saint Petersburg State Medical University, 6-8 Lev Tolstoy Street, 197022 Saint Petersburg, Russia.
³ Saint Petersburg Electrotechnical University "LETI", 5 Professora Popova Street, 197376 Saint Petersburg, Russia.
⁴ Peter the Great Saint Petersburg Polytechnic University, 29 Polytechnicheskaya str., 195251 Saint Petersburg, Russia.

Abstract

The post-ischemic no-reflow phenomenon after primary percutaneous coronary intervention (PCI) is observed in more than half of subjects and is defined as the absence or marked slowing of distal coronary blood flow despite removal of the arterial occlusion. To visualize no-reflow in experimental studies, the fluorescent dye thioflavin S (ThS) is often used, which allows for the estimation of the size of microvascular obstruction by staining the endothelial lining of vessels. Based on the ability of indocyanine green (ICG) to be retained in tissues with increased vascular permeability, we proposed the possibility of using it to assess not only the severity of microvascular obstruction but also the degree of vascular permeability in the zone of myocardial infarction. The aim of our study was to investigate the possibility of using ICG to visualize no-reflow zones after ischemia-reperfusion injury of rat myocardium. Using dual ICG and ThS staining and the FLUM multispectral fluorescence organoscope, we recorded ICG and ThS fluorescence within the zone of myocardial necrosis, identifying ICG-negative zones whose size correlated with the size of the no-reflow zones detected by ThS. It is also shown that the contrast change between the no-reflow zone and nonischemic myocardium reflects the severity of blood stasis, indicating that ICG-negative zones are no-reflow zones. The described method can be an addition or alternative to the traditional method of measuring the size of no-reflow zones in the experiment.