Document Detail


Coronary artery flow velocity profile measured by transthoracic Doppler echocardiography predicts myocardial viability after acute myocardial infarction.
MedLine Citation:
PMID:  17135221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study whether flow velocity profile in the left anterior descending coronary artery (LAD) measured by transthoracic Doppler echocardiography (TTDE) predicts myocardial viability after reperfused anterior acute myocardial infarction (AMI). PATIENTS AND METHODS: 15 patients who had their first anterior ST elevation AMI and were successfully reperfused by coronary angioplasty and five controls without coronary artery disease were selected. Blood flow velocity spectrum was measured from the mid-LAD by TTDE 3 days after coronary angioplasty. Myocardial viability in the LAD region was quantified 3 months after AMI by relative uptake of 18F-fluorodeoxyglucose (FDG) imaged with positron emission tomography. Myocardium was graded as viable, partially viable or non-viable (relative FDG uptake >85%, 67-85% and <67%, respectively). Main outcome measures were diastolic deceleration time (DDT) of LAD flow velocity 3 days after AMI and myocardial viability 3 months after AMI. RESULTS: DDT of LAD flow velocity correlated with myocardial FDG uptake in the LAD region (r = 0.91, p<0.01). DDT was markedly longer in patients with viable myocardium (876+/-76 ms, n = 3) than partially viable (356+/-89 ms, n = 6, p<0.01), or non-viable myocardium (128+/-13 ms, n = 6, p<0.01). In controls, DDT was comparable (909+/-76 ms, n = 5) to patients with viable myocardium. DDT <190 ms was always associated with non-viable myocardium. CONCLUSIONS: DDT of LAD flow velocity is strongly associated with myocardial viability after reperfused anterior AMI. Non-invasive TTDE of the LAD may be used in the acute phase to predict long-term viability of the jeopardised myocardium.
Authors:
Antti Saraste; Juha W Koskenvuo; Markku Saraste; Jussi Pärkkä; Jyri Toikka; Alexandru Naum; Heikki Ukkonen; Juhani Knuuti; Juhani Airaksinen; Jaakko Hartiala
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-11-29
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  93     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-02     Completed Date:  2007-04-26     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  456-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 6-8, 20520 Turku, Finland. antti.saraste@utu.fi
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity / physiology
Coronary Circulation / physiology
Coronary Vessels / physiopathology*
Echocardiography / standards
Echocardiography, Doppler / standards
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology*
Myocardial Reperfusion
Positron-Emission Tomography / methods
Radiopharmaceuticals / diagnostic use
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections

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