| Time course of impaired coronary flow reserve after reperfusion in patients with acute myocardial infarction. | |
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MedLine Citation:
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PMID: 8914871 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Ishihara; H Sato; H Tateishi; T Kawagoe; Y Shimatani; S Kurisu; K Sakai |
Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 78 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1996 Nov |
Date Detail:
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Created Date: 1997-01-02 Completed Date: 1997-01-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1103-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Hiroshima City Hospital, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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58-32-2/Dipyridamole |
| Comments/Corrections | |
Comment In:
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Am J Cardiol. 1997 Jul 1;80(1):109
[PMID:
9205037
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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