Document Detail

Integrated analysis of myocardial blush and ST-segment elevation recovery after successful primary angioplasty: Real-time grading of microvascular reperfusion and prediction of early and late recovery of left ventricular function.
MedLine Citation:
PMID:  12119246     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: ST-segment elevation (SigmaSTe) recovery and the angiographic myocardial blush (MB) grade are useful markers of microvascular reperfusion after recanalization of the infarct-related artery. We investigated the ability of a combined analysis of MB grade and SigmaSTe changes to identify different patterns of myocardial reperfusion shortly after primary percutaneous coronary angioplasty (PTCA) and to predict 7-day and 6-month left ventricular (LV) functional recovery. METHODS AND RESULTS: MB grade and SigmaSTe recovery were evaluated shortly after successful primary PTCA (restoration of TIMI grade 3 flow) in 114 consecutive patients with SigmaSTe acute myocardial infarction. LV function was assessed by 2D echocardiograms before PTCA and at 7 days and 6 months thereafter. By combining MB and SigmaSTe changes, 3 main groups of patients were identified. Group 1 patients (n=60) had both significant MB (grade 2 to 3) and SigmaSTe recovery (>50% versus basal SigmaSTe) and a high rate of 7-day (65%) and 6-month (95%) LV functional recovery. In group 2 patients (n=21), who showed MB but persistent SigmaSTe, the prevalence of early LV functional recovery was low (24%) but increased up to 86% in the late phase. Group 3 patients (n=28), who had neither significant MB nor SigmaSTe resolution, had poor early (18%) and late (32%) LV functional recovery. CONCLUSIONS: After successful primary PTCA, integrated analysis of MB and SigmaSTe recovery allows a real-time grading of microvascular reperfusion of the infarct area and predicts the time-course and magnitude of LV functional recovery.
Arnaldo Poli; Raffaela Fetiveau; Pietro Vandoni; Gianfranco del Rosso; Maurizio D'Urbano; Giovanni Seveso; Francesco Cafiero; Stefano De Servi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-16     Completed Date:  2002-07-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  313-8     Citation Subset:  AIM; IM    
Division of Cardiology, Ospedale Civile di Legnano, Legnano (MI), Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography / methods*
Coronary Circulation
Electrocardiography / methods*
Middle Aged
Myocardial Infarction / diagnosis*,  radiography,  therapy*
Treatment Outcome
Ventricular Function, Left

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

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