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    
Abstract/OtherAbstract:
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.
Authors:
Arnaldo Poli; Raffaela Fetiveau; Pietro Vandoni; Gianfranco del Rosso; Maurizio D'Urbano; Giovanni Seveso; Francesco Cafiero; Stefano De Servi
Related Documents :
7475656 - First-year results of cabri (coronary angioplasty versus bypass revascularisation inves...
16098386 - Safety of coronary angioplasty to chronic total occlusions.
2187576 - Usefulness of coronary artery angioplasty strategies in acute myocardial infarction.
2963516 - Percutaneous transluminal coronary angioplasty for angina pectoris after a non-q-wave a...
22518106 - Prevention of postoperative atrial fibrillation: novel and safe strategy based on the m...
22412246 - Impact of a large hemodialysis arteriovenous fistula: on myocardial protection during c...
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    
Affiliation:
Division of Cardiology, Ospedale Civile di Legnano, Legnano (MI), Italy. arnaldopoli@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography / methods*
Coronary Circulation
Echocardiography
Electrocardiography / methods*
Female
Humans
Kinetics
Male
Microcirculation
Middle Aged
Myocardial Infarction / diagnosis*,  radiography,  therapy*
Prognosis
Treatment Outcome
Ventricular Function, Left

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


Previous Document:  Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment el...
Next Document:  Assessment of survival in patients with primary pulmonary hypertension: importance of cardiopulmonar...