Document Detail


Time course and relation to local viability of microvascular function and volume after reperfused acute myocardial infarction.
MedLine Citation:
PMID:  12062725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assessed the time course of the alterations of microvascular function and myocardial perfusion, as well their relation to local inotropic reserve (IR), in 21 patients who underwent successful primary coronary angioplasty for acute myocardial infarction and in whom local myocardial dysfunction persisted at hospital discharge. Coronary flow reserve (CFR) and myocardial perfusion were assessed immediately after angioplasty, and on day 1 and day 8 by intracoronary Doppler and myocardial contrast echocardiography, respectively. Dobutamine echocardiography was performed on day 7 for assessment of local IR. After angioplasty, CFR was severely altered in patients with (n = 14) and without (n = 7) IR (1.44 +/- 0.26 and 1.36 +/- 0.21, respectively; p = NS). Among patients with IR, CFR increased significantly at day 1 (2.26 +/- 0.62, p <0.005 vs acute stage) compared with those without IR (p = NS vs acute). In contrast, the extent of microvascular obstruction as defined by contrast echocardiography remained unchanged in all patients at day 1 compared with acute measurements. Microvascular obstruction decreased at day 8 in the sole subset of patients with local IR (p <0.05 vs acute stage). In patients treated by immediate coronary angioplasty for acute myocardial infarction, subsequent improvement of myocardial perfusion is associated with preexistent recruitable microvascular function in the infarct-related artery. The presence of reversible microvascular dysfunction at the early stage after acute myocardial infarction is associated with local tissue viability in humans.
Authors:
Philippe Garot; Olivier Pascal; Marc Simon; Jean-Luc Monin; Patrick Dupouy; Nathalie Elbaz; Emmanuel Teiger; Jérôme Garot; Pascal Guéret; Jean-Luc Dubois-Randé
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  89     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-13     Completed Date:  2002-07-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1341-6     Citation Subset:  AIM; IM    
Affiliation:
Fédération de Cardiologie, Hôpital Henri Mondor, INSERM U400, Créteil, France. philippe.garot@hmn.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Angioplasty, Balloon
Cardiotonic Agents / diagnostic use
Contrast Media
Coronary Angiography
Coronary Circulation
Dobutamine / diagnostic use
Echocardiography / methods
Female
Humans
Male
Microcirculation
Middle Aged
Myocardial Infarction / physiopathology*,  radiography,  surgery*,  ultrasonography
Stroke Volume
Time Factors
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Contrast Media; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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