Document Detail


Coronary flow velocity pattern assessed by transthoracic Doppler echocardiography predicts adverse clinical events and myocardial recovery after successful primary angioplasty.
MedLine Citation:
PMID:  17001237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Doppler guidewire studies demonstrated that specific velocity patterns in the left anterior descending coronary artery (LAD) after primary percutaneous coronary intervention (PCI) predict myocardial recovery and clinical outcome. The present study assessed whether similar results can be achieved by transthoracic Doppler echocardiography (TTDE). METHODS: Coronary flow velocities of LAD were evaluated by TTDE in 35 consecutive patients with anterior acute myocardial infarction who were treated with successful primary PCI plus stenting, performed within 6 h after the onset of symptoms or within 6-12 h if there was evidence of continuing ischaemia. Coronary-flow velocity of the LAD was achieved after 12 h and within 48 h after the PCI; TTDE standard examination was repeated after 2 months of follow-up. RESULTS: Three patterns were found: (i) 'pattern A' with good antegrade systolic flow and slow diastolic deceleration rate (63.7%); (ii) 'pattern B' with reduced or absent systolic flow and rapid diastolic deceleration rate (9.1%); and (iii) 'pattern C' with protosystolic retrograde flow and rapid diastolic deceleration rate (27.2%). The clinical characteristics and echocardiographic data were compared: wall-motion-score-index (WMSI), ejection fraction, end-diastolic volume (EDV) after PCI (T1) and after 2 months (T2). Patients with pattern A demonstrated recovery of contractile function (WMSI-T1 1.48 + or - 0.42/WMSI-T2 1.29 + or - 0.29, P < 0.05) and better clinical outcome; patients with patterns B and C ran into ventricular remodelling (EDV-T1 89 + or - 6.3 ml/EDV-T2 123 + or - 25 ml, P = 0.002) and more early and late complications. CONCLUSIONS: TTDE is a reliable method to achieve coronary flow velocities in LAD after an anterior acute myocardial infarction and it could be useful to evaluate no-reflow phenomenon at bedside and thus clinical outcome.
Authors:
Francesco Agostini; Maria Alessandra Iannone; Raffaele Mazzucco; Francesca Cionini; Nicola Baccaglioni; Corrado Lettieri; Divo Belfanti; Luca Tomasi; Antonio Izzo; Maria Rosa Ferrari; Maria Cristiana Brunazzi; Roberto Zanini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  7     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-26     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  753-60     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Carlo Poma Hospital, via Albertoni, no. 1, 46100 Mantua, Italy. f_agostini@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Blood Flow Velocity
Cohort Studies
Coronary Angiography / methods
Coronary Circulation / physiology
Coronary Vessels / ultrasonography*
Echocardiography*
Echocardiography, Doppler
Electrocardiography
Emergency Treatment
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  radiography,  therapy*
Myocardial Reperfusion Injury / physiopathology,  ultrasonography*
Predictive Value of Tests
Probability
Reproducibility of Results
Risk Assessment
Severity of Illness Index
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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