This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wakatsuki, T. Articles by Yamaguchi, T. Search for Related Content PubMed PubMed Citation Articles by Wakatsuki, T. Articles by Yamaguchi, T.

CLINICAL STUDIES

Coronary flow velocity immediately after primary coronary stenting as a predictor of ventricular wall motion recovery in acute myocardial infarction

^b Second Department of Internal Medicine, University of Tokushima, Tokushima, Japan
^* the Third Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan

Manuscript received January 15, 1999; revised manuscript received December 16, 1999, accepted February 14, 2000.

Reprint requests and correspondence: Tetsuzo Wakatsuki, Second Department of Internal Medicine, School of Medicine, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima 770-8503, Japan
wakatsuki{at}clin.med.tokushima-u.ac.jp

OBJECTIVES

The purpose of this study was to examine the relationship between the pattern of coronary blood flow velocity immediately after successful primary stenting and the recovery of left ventricular (LV) wall motion in patients with acute myocardial infarction (AMI).

BACKGROUND

It is difficult to predict the recovery of LV wall motion immediately after direct angioplasty in AMI. Recent reports indicate that dysfunctional coronary microcirculation is an important determinant of prognosis for AMI patients after successful reperfusion.

METHODS

We measured left anterior descending coronary flow velocity variables using a Doppler guide wire immediately after successful primary stenting in 31 patients with their first anterior AMI. The patients were divided into two groups: those with and those without early systolic reverse flow (ESRF). Changes in LV regional wall motion (RWM) and ejection fraction (EF) at admission and at discharge were compared between the two groups. Coronary flow velocity variables immediately after primary stenting were compared with changes in left ventriculographic indexes.

RESULTS

The change in RWM was significantly greater in the non-ESRF group than it was in the ESRF group (0.9 ± 0.7 vs. –0.1 ± 0.3 standard deviation/chord, respectively, p < 0.001). The change in EF was also significantly greater in the non-ESRF group than it was in the ESRF group (10 ± 10 vs. 1 ± 6%, respectively, p < 0.05). In the non-ESRF group (diastolic to systolic velocity ratio [DSVR] <3.0), the DSVR correlated positively with the change in RWM (r = 0.60, p < 0.005, n = 24) and the change in EF (r = 0.52, p < 0.01).

CONCLUSIONS

The coronary flow velocity pattern measured immediately after successful primary stenting is predictive of the recovery of regional and global LV function in patients with AMI.

Abbreviations and Acronyms   ANCOVA = analysis of covariance   AMI = acute myocardial infarction   CPK = creatine phosphokinase   DSVR = diastolic to systolic velocity ratio of coronary flow   EF = ejection fraction   ESRF = early systolic reverse flow   LAD = left anterior descending coronary artery   LV = left ventricle   RWM = regional wall motion   SD = standard deviation   TIMI = Thrombolysis in Myocardial Infarction

This article has been cited by other articles:

				H. Kitabata, T. Imanishi, T. Kubo, S. Takarada, M. Kashiwagi, H. Matsumoto, H. Tsujioka, H. Ikejima, Y. Arita, K. Okochi, et al. Coronary Microvascular Resistance Index Immediately After Primary Percutaneous Coronary Intervention as a Predictor of the Transmural Extent of Infarction in Patients With ST-Segment Elevation Anterior Acute Myocardial Infarction. J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 263 - 272. [Abstract] [Full Text] [PDF]

				M. J. Kern, A. Lerman, J.-W. Bech, B. De Bruyne, E. Eeckhout, W. F. Fearon, S. T. Higano, M. J. Lim, M. Meuwissen, J. J. Piek, et al. Physiological Assessment of Coronary Artery Disease in the Cardiac Catheterization Laboratory: A Scientific Statement From the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology Circulation, September 19, 2006; 114(12): 1321 - 1341. [Abstract] [Full Text] [PDF]

				M. Ferenc and F.-J. Neumann Efficacy of primary PCI: the microvessel perspective Eur. Heart J. Suppl., October 1, 2005; 7(suppl_I): I4 - I9. [Abstract] [Full Text] [PDF]

				M. Gick, N. Jander, H.-P. Bestehorn, R.-P. Kienzle, M. Ferenc, K. Werner, T. Comberg, K. Peitz, D. Zohlnhofer, V. Bassignana, et al. Randomized Evaluation of the Effects of Filter-Based Distal Protection on Myocardial Perfusion and Infarct Size After Primary Percutaneous Catheter Intervention in Myocardial Infarction With and Without ST-Segment Elevation Circulation, September 6, 2005; 112(10): 1462 - 1469. [Abstract] [Full Text] [PDF]

				M Kato, K Dote, S Sasaki, K Goto, H Takemoto, S Habara, and D Hasegawa Myocardial performance index for assessment of left ventricular outcome in successfully recanalised anterior myocardial infarction Heart, May 1, 2005; 91(5): 583 - 588. [Abstract] [Full Text] [PDF]

				Y Ohara, Y Hiasa, T Takahashi, K Yamaguchi, R Ogura, T Ogata, K Yuba, K Kusunoki, S Hosokawa, K Kishi, et al. Relation between the TIMI frame count and the degree of microvascular injury after primary coronary angioplasty in patients with acute anterior myocardial infarction Heart, January 1, 2005; 91(1): 64 - 67. [Abstract] [Full Text] [PDF]

				A. P. Furber, F. Prunier, H. C. P. Nguyen, S. Boulet, S. Delepine, and P. Geslin Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events Circulation, December 7, 2004; 110(23): 3527 - 3533. [Abstract] [Full Text] [PDF]

				M. Bax, R. J. de Winter, C. E. Schotborgh, K. T. Koch, M. Meuwissen, M. Voskuil, R. Adams, K. J. J. Mulder, J. G. P. Tijssen, and J. J. Piek Short- and Long-Term recovery of left ventricular function predicted at the time of primary percutaneous coronary intervention in anterior myocardial infarction J. Am. Coll. Cardiol., February 18, 2004; 43(4): 534 - 541. [Abstract] [Full Text] [PDF]

				R Hoffmann, P Haager, W Lepper, A Franke, and P Hanrath Relation of coronary flow pattern to myocardial blush grade in patients with first acute myocardial infarction Heart, October 1, 2003; 89(10): 1147 - 1151. [Abstract] [Full Text] [PDF]

				P. Garot Prognostic significance of coronary blood flow velocity patterns in patients with reperfused acute myocardial infarction and TIMI-2 flow J. Am. Coll. Cardiol., July 2, 2003; 42(1): 182 - 182. [Full Text] [PDF]

				Y Nohtomi, M Takeuchi, K Nagasawa, K Arimura, K Miyata, K Kuwata, T Yamawaki, S Kondo, A Yamada, and S Okamatsu Persistence of systolic coronary flow reversal predicts irreversible dysfunction after reperfused anterior myocardial infarction Heart, April 1, 2003; 89(4): 382 - 388. [Abstract] [Full Text] [PDF]

				Y. Abe, M. Kondo, R. Matsuoka, M. Araki, K. Dohyama, and H. Tanio Assessment of clinical features in transient left ventricular apical ballooning J. Am. Coll. Cardiol., March 5, 2003; 41(5): 737 - 742. [Abstract] [Full Text] [PDF]

				F Beygui, C Le Feuvre, G Helft, C Maunoury, and J P Metzger Myocardial viability, coronary flow reserve, and in-hospital predictors of late recovery of contractility following successful primary stenting for acute myocardial infarction Heart, February 1, 2003; 89(2): 179 - 183. [Abstract] [Full Text] [PDF]

				A. Yamamuro, T. Akasaka, K. Tamita, K. Yamabe, M. Katayama, T. Takagi, and S. Morioka Coronary Flow Velocity Pattern Immediately After Percutaneous Coronary Intervention as a Predictor of Complications and In-Hospital Survival After Acute Myocardial Infarction Circulation, December 10, 2002; 106(24): 3051 - 3056. [Abstract] [Full Text] [PDF]

				F.-J. Neumann and N. Jander How to best counteract the enemies? By ensuring adequate oxygen delivery Eur. Heart J. Suppl., November 1, 2002; 4(suppl_G): G35 - G42. [Abstract] [PDF]

				P. Voci, E. Mariano, F. Pizzuto, P. E. Puddu, and F. Romeo Coronary recanalization in anterior myocardial infarction: The open perforator hypothesis J. Am. Coll. Cardiol., October 2, 2002; 40(7): 1205 - 1213. [Abstract] [Full Text] [PDF]

				W. Lepper, G. T. j Sieswerda, A. Franke, N. Heussen, O. Kamp, C. C. de Cock, E. R. Schwarz, P. Voci, C. A. Visser, P. Hanrath, et al. Repeated assessment of coronary flow velocity pattern in patients with first acute myocardial infarction J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1283 - 1289. [Abstract] [Full Text] [PDF]

				G. W. Stone, C. L. Grines, D. A. Cox, E. Garcia, J. E. Tcheng, J. J. Griffin, G. Guagliumi, T. Stuckey, M. Turco, J. D. Carroll, et al. Comparison of Angioplasty with Stenting, with or without Abciximab, in Acute Myocardial Infarction N. Engl. J. Med., March 28, 2002; 346(13): 957 - 966. [Abstract] [Full Text] [PDF]

				S. Hamada, T. Nishiue, S. Nakamura, T. Sugiura, H. Kamihata, H. Miyoshi, Y. Imuro, and T. Iwasaka TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction J. Am. Coll. Cardiol., September 1, 2001; 38(3): 666 - 671. [Abstract] [Full Text] [PDF]