Document Detail


Time course of impaired coronary flow reserve after reperfusion in patients with acute myocardial infarction.
MedLine Citation:
PMID:  8914871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the time course of coronary flow reserve after reperfusion, 14 patients with a first anterior wall acute myocardial infarction who underwent successful coronary angioplasty within 6 hours after symptom onset were studied. After angioplasty, coronary flow reserve of the left anterior descending artery was measured with a coronary Doppler guidewire and intravenous dipyridamole (0.56 mg/kg over 4 minutes). Measurements were repeated at predischarge (16 +/- 3 days, n = 12) and at follow-up (6 +/- 3 months, n = 9). Patients with restenosis at the time of repeat catheterization were excluded. An additional 13 patients with normal angiograms served as reference patients. Coronary flow reserve was 1.33 +/- 0.29 after angioplasty. It increased to 1.88 +/- 0.36 at predischarge (p <0.01) and further to 2.34 +/- 0.38 at follow-up (p <0.01 vs after angioplasty and at predischarge, respectively). However, compared with reference patients (3.15 +/- 0.48), coronary flow reserve was significantly reduced in the infarct patients even at follow-up (p <0.01). In infarct patients, the infarct region wall motion was initially -3.86 +/- 0.67 SD/chord. It significantly improved to -2.07 +/- 1.04 SD/chord at predischarge (p <0.01) and to -1.67 +/- 1.43 SD/chord at follow-up (p <0.01). However, there was no significant relation between coronary flow reserve and region wall motion after angioplasty (r = 0.10), at predischarge (r = 0.35), and at follow-up (r = 0.28). Thus, coronary flow reserve is severely impaired early after reperfusion. Coronary flow reserve improves over 2 weeks, but the impairment persists at 6 months after acute myocardial infarction. The impairment of coronary flow reserve cannot be predicted by left ventricular function. Small sample size is a potential limitation of this study, and a larger study should be performed to confirm these findings.
Authors:
M Ishihara; H Sato; H Tateishi; T Kawagoe; Y Shimatani; S Kurisu; K Sakai
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-01-02     Completed Date:  1997-01-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1103-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hiroshima City Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Blood Flow Velocity
Coronary Angiography
Coronary Circulation / physiology*
Dipyridamole / diagnostic use
Female
Follow-Up Studies
Heart Catheterization
Hemodynamics / physiology
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology*,  therapy*
Myocardial Reperfusion / adverse effects*
Ultrasonography, Doppler
Ventricular Function, Left / physiology
Chemical
Reg. No./Substance:
58-32-2/Dipyridamole
Comments/Corrections
Comment In:
Am J Cardiol. 1997 Jul 1;80(1):109   [PMID:  9205037 ]

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