Document Detail

Early temporal changes in coronary flow velocity patterns in patients with acute myocardial infarction demonstrating the "no-reflow" phenomenon.
MedLine Citation:
PMID:  10468079     Owner:  NLM     Status:  MEDLINE    
Coronary flow velocity pattern in patients with acute myocardial infarction demonstrating no-reflow phenomenon is characterized with early systolic retrograde flow and rapid deceleration of diastolic flow velocity. In this study, we investigated the early temporal changes in microvascular function in patients with the no-reflow phenomenon. Among 144 patients with a first acute myocardial infarction, 33 exhibited sizable no-reflow phenomenon after coronary reperfusion with myocardial contrast echocardiography. We assessed temporal changes in coronary flow velocity patterns with the Doppler guidewire. The early systolic retrograde flow was observed < or = 10 seconds after reperfusion in 16 patients (group A) or later in 17 patients (331 +/- 327 seconds, group B). Diastolic deceleration rate was higher in group A than in group B at 1 minute after reperfusion. It gradually increased in group B and showed comparable value to group A 10 minutes later. Group A had longer elapsed time from symptom onset to reperfusion and a greater number of infarct Q waves before reperfusion than group B (14 +/- 13 vs 5 +/- 2 hours, p <0.01; and 3 +/- 2 vs 2 +/- 1, p <0.02). In contrast, the incidence of transient ST reelevation shortly after reperfusion was higher in group B (76% vs 25%, p <0.01). Thus, the characteristic coronary flow velocity pattern is either established at the moment of coronary reperfusion or progresses thereafter in patients with no-reflow phenomenon. This suggests different mechanisms of developing ischemic microvascular injury.
K Iwakura; H Ito; N Nishikawa; K Hiraoka; K Sugimoto; Y Higashino; T Masuyama; M Hori; K Fujii; T Minamino
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  84     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-15     Completed Date:  1999-09-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  415-9     Citation Subset:  AIM; IM    
Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Blood Flow Velocity
Coronary Angiography
Coronary Circulation*
Echocardiography, Doppler, Color
Follow-Up Studies
Heart Catheterization
Middle Aged
Myocardial Contraction
Myocardial Infarction / diagnosis,  physiopathology*,  therapy
Reproducibility of Results
Retrospective Studies

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

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