Document Detail


Quantitative estimation of myocardial salvage after primary percutaneous transluminal coronary angioplasty in patients with angiographic no reflow.
MedLine Citation:
PMID:  12634966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angiographic Thrombolysis in Myocardial Infarction (TIMI) flow grade <or=2 after primary percutaneous transluminal coronary angioplasty (PTCA), defined as angiographic no reflow, predicts poor left ventricular functional recovery and survival in patients with acute myocardial infarction (MI). To determine the relation between angiographic coronary flow and myocardial salvage in the acute phase of MI, serial technetium-99m tetrofosmin imaging was performed before, immediately after and 1 month after PTCA in 117 patients. Angiographic no reflow was observed in 23 patients (20%; group 1), while 94 patients did not have angiographic no reflow (group 2). Although there was no significant difference in the defect score before PTCA between the two groups (group 1, 14.4+/-5.7; group 2, 13.5+/-4.6), the defect score immediately after PTCA in group 1 was significantly higher than that in group 2 (group 1, 12.8+/-5.1; group 2, 8.9+/-4.6; P<0.0001). A significantly smaller change in the defect score after PTCA (before minus immediately after PTCA) was observed in group 1 as compared with group 2 (group 1, 1.7+/-2.0; group 2, 4.5+/-2.9; P<0.0001). Twenty patients in group 1 (87%) had impaired myocardial reperfusion (<4 change in the defect score immediately after PTCA), as compared with 36 patients (38%) in group 2; this difference was significant (chi(2)=17.5, P<0.0001). The sensitivity, specificity and accuracy of angiographic no reflow in estimating impaired myocardial reperfusion were 36%, 95% and 67%, respectively. Thus, angiographic no reflow is a highly specific, although not sensitive, marker of impaired myocardial reperfusion immediately after primary PTCA.
Authors:
Seishi Nakamura; Kazuya Takehana; Tetsuro Sugiura; Kengo Hatada; Shinichi Hamada; Junko Asada; Reisuke Yuyama; Jun Mimura; Yusuke Imuro; Hirohiko Kurihara; Masayoshi Fukui; Masato Baden; Toshiji Iwasaka
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Validation Studies     Date:  2002-12-19
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  30     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-13     Completed Date:  2004-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  383-9     Citation Subset:  IM    
Affiliation:
The Second Department of Internal Medicine, Cardiovascular Centre, Kansai Medical University, 10-15 Fumizono-cho, 570-8507 Moriguchi, Osaka, Japan. nakamurs@takii.kmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects
Coronary Angiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications,  radiography,  radionuclide imaging*,  therapy*
Myocardial Reperfusion Injury / etiology,  radiography,  radionuclide imaging*
Organophosphorus Compounds / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Ventricular Dysfunction, Left / etiology,  radiography*,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

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