Document Detail


Plain computed tomography for assessment of early coronary microcirculatory damage after revascularization therapy in acute myocardial infarction.
MedLine Citation:
PMID:  17062974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary microcirculatory damage is an important factor for the prognosis for acute myocardial infarction (MI) after revascularization. The myocardial enhancement area with contrast media infused during coronary revascularization therapy, detected by computed tomography (CT) just after revascularization, has been reported to correspond to the area of hemorrhagic infarction. The relationship between myocardial contrast enhancement and coronary microcirculatory damage was investigated in the present study. METHODS AND RESULTS: Thirteen patients with acute anterior MI underwent successful coronary revascularization within 6 h of symptom onset were enrolled. The coronary flow velocity pattern was measured using a Doppler guidewire and chest CT assessments were performed immediately after coronary revascularization. The ratio of mean CT number of the highest-enhanced myocardial area and the lumen of the left ventricle was defined as a relative CT number. The relative CT number significantly correlated with coronary diastolic deceleration time (r=-0.78, p<0.002) and coronary diastolic deceleration rate (r=0.74, p<0.04). It also correlated with peak myocardial enzyme release in plasma. CONCLUSION: Myocardial contrast enhancement detected using plain CT just after coronary reperfusion therapy implies coronary microcirculatory damage in acute MI. The relative CT number is useful in evaluating the impaired coronary microcirculatory state.
Authors:
Masaya Kato; Keigo Dote; Shota Sasaki; Kentaro Ueda; Kenji Goto; Hiroaki Takemoto; Seiji Habara; Daiji Hasegawa; Osamu Matsuda; Yoshinori Nakano; Toru Naganuma
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  70     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-25     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1475-80     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima 731-0221, Japan. ms-katou@asa-hosp.city.hiroshima.jp
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Contrast Media / administration & dosage
Coronary Circulation / physiology
Coronary Vessels / physiopathology*
Diastole
Echocardiography, Doppler
Female
Humans
Male
Microcirculation / physiopathology,  radiography
Middle Aged
Myocardial Infarction / physiopathology,  surgery*
Myocardial Reperfusion
Myocardial Reperfusion Injury / etiology,  physiopathology*,  radiography*
Myocardial Revascularization / adverse effects,  methods*
Regional Blood Flow / physiology
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media

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