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Left anterior descending coronary artery flow after primary angioplasty in acute anterior ST-elevation myocardial infarction: How much flow is needed for left ventricular functional recovery?
MedLine Citation:
PMID:  24493865     Owner:  NLM     Status:  Publisher    
AIM: Serial assessment of left anterior descending (LAD) coronary artery flow in patients with anterior myocardial infarction (MI), immediately after PPCI, 48 h later and pre-discharge and compare findings in patients with optimal and suboptimal PPCI result and their relation to left ventricular ejection fraction (LVEF).
METHODS: Velocities in the LAD were recorded within 6 h after PPCI and one week later in 36 patients presenting with acute anterior STEMI. Sixteen patients had TIMI and MBG less than 3 after PPCI were considered to have suboptimal result. Sampling of LAD coronary artery velocity was obtained from trans-thoracic Doppler. Flow in the LAD coronary artery was estimated using heart rates, Doppler time velocity integrals and LAD color Doppler diameters.
RESULTS: Diastolic LAD coronary artery flow immediately after PPCI in subjects with suboptimal PPCI, 29±21 ml/min was lower than in those with optimal result, 39.8±21 ml/min, p<0.05. Diastolic flow in the LAD coronary artery increased to 50.3±28.5 ml/min two days after PPCI in patients with suboptimal PPCI, p=0.04, and to 49.6±13.8 ml/min in those optimal result, p=0.04. LVEF increased by 9% in patients with optimal PPCI, p=0.004, and did not change in the other group.
CONCLUSIONS: (a) After PPCI, flow in the LAD coronary artery was dynamic; (b) in the presence of suboptimal PPCI, early LAD coronary artery flow was reduced; (c) pre-discharge, LAD coronary artery flow increased; and (d) LVEF increased only in optimal PPCI group associated with higher early LAD coronary artery flow.
Dawod Sharif; Amal Sharif-Rasslan; Amin Khalil; Uri Rosenschein
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-3
Journal Detail:
Title:  European heart journal. Acute cardiovascular care     Volume:  -     ISSN:  2048-8734     ISO Abbreviation:  Eur Heart J Acute Cardiovasc Care     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101591369     Medline TA:  Eur Heart J Acute Cardiovasc Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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