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Record W7127132741 · doi:10.18103/mra.v14i1.7190

A Review of Non-Invasive Acoustic Reperfusion Technologies for STEMI

2025· article· W7127132741 on OpenAlex
Andrew Hoffmann

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueMedical Research Archives · 2025
Typearticle
Language
FieldMedicine
TopicPhonocardiography and Auscultation Techniques
Canadian institutionsCanadian Bio-Systems (Canada)
Fundersnot available
KeywordsMyocardial infarctionBlood pressureArteryBlood flowPercutaneousPercutaneous coronary interventionDosing

Abstract

fetched live from OpenAlex

St-Elevation Myocardial Infarction (STEMI), commonly an acute, occlusive blood clot in a major epicardial coronary artery, is the most serious of heart attacks, carrying a significant mortality and morbidity, and opening the occluded artery quickly with good distal reflow is the goal for best clinical outcomes. Slow arrival of Emergency Health Services (EHS), a lack of Cathlab availability in underdeveloped and rural areas, poor performance and bleeding risks with thrombolytic drug therapy, and a high rate of poor microvascular re-flow regardless of therapy, have prompted searches for alternative or adjunctive treatments. Mechanical forces or pressure waves imparted to the human body (herein described as “Acoustic Therapies”) have been well studied both in vitro and in catheter-based systems in their abilities to increase blood flow and disrupt and clear blood clots. However, the search for a non-invasive acoustic therapy suitable for first-line response in the treatment of acute thrombotic arterial occlusions, including STEMI, remains elusive. Indeed, due to the vast differences of acoustic penetration windows and variabilities of at-risk adjacent tissues, there has been a historic dilemma of “threading the needle” in finding a workable waveform and mode of delivery that is intense enough to provide adequate penetration with a clot-disruptive effect, while also avoiding harm to the patient. STEMI victims who reach professional care in view of Primary Percutaneous Coronary Intervention (PPCI) or pre-hospital IV thrombolysis, reportedly have a ~ 4-10% resultant in-hospital mortality, with the number approaching 50% if complicated by cardiogenic shock, hence there remains room for improvement. Indeed, acoustic reperfusion for STEMI could foreseeably add particular value as a stand-alone therapy or adjunctive to IV thrombolysis in rural or relatively poor areas where a Cardiac Cathlab is not readily available, as an early warning and treatment system for STEMI patients awaiting EHS, and, importantly, for treatment of the infamous "No-Reflow phenomenon" following PPCI, where many solutions have been tried and failed. This paper provides a history and commentary on the various forwarded non-invasive acoustic STEMI reperfusion strategies to date, including High Frequency diagnostic UltraSound (HFUS) with IV Microbubbles (MBs) - a technique commonly referred to as "Sonothrombolysis", transcutaneous Low Frequency Ultrasound (LFUS), and little-known diastolic timed Low Frequency Vibration (dtLFV), which involves palpable, infrasonic to sonic frequency percussions to the chest wall as a stand-alone measure, or as an adjunct to IV thrombolysis. A discussion is provided on each of these therapies' challenges, how they could fit in the modern paradigm of care, and where they are along their respective research and development pathways.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.006
metaresearch head score (Gemma)0.094
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Science and technology studies
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.717
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0060.094
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.003
Science and technology studies0.0000.004
Scholarly communication0.0000.000
Open science0.0010.001
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.036
GPT teacher head0.428
Teacher spread0.392 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it