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Repeated assessment of coronary flow velocity pattern in patients with first acute myocardial infarction

Wolfgang Lepper, MD^*, Gertjan T. j Sieswerda, MD, Andreas Franke, MD^*, Nicole Heussen, Otto Kamp, MD, PhD, Carel C. de Cock, MD, Ernst R. Schwarz, MD^*, Paolo Voci, MD, PhD, Cees A. Visser, MD, PhD, FACC, Peter Hanrath, MD, FACC^* and Rainer Hoffmann, MD^*,*

^* Medical Clinic I, University Hospital RWTH Aachen, Germany
Department of Cardiology, University Hospital VU, Amsterdam, The Netherlands
Department of Biomedical Statistics, University RWTH, Aachen, Germany
Core Laboratory (CLIP), Pisa, Italy

View larger version (86K): [in a new window]   Figure 1 Myocardial contrast echocardiography (MCE) at end-systole (apical four-chamber view [A]) 24 h after percutaneous transluminal coronary angioplasty in a patient with nonreperfusion (arrowheads) defined by MCE after anterior acute myocardial infarction. The coronary flow velocity pattern in the left anterior descending artery immediately after revascularization (B) and at 24 h follow-up (C) showed retrograde systolic flow (arrow) and rapid deceleration of diastolic flow. There is a slight improvement in flow pattern during follow-up. ASPV = average peak flow velocity; DDT = diastolic deceleration time; DSVR = diastolic-systolic velocity ratio.

View larger version (83K): [in a new window]   Figure 2 Myocardial contrast echocardiography (MCE) at end systole (apical two-chamber view [A]) 24 h after percutaneous transluminal coronary angioplasty in a patient with reperfusion (arrowheads) defined by MCE after inferior acute myocardial infarction. The coronary flow velocity pattern in the right coronary artery immediately after revascularization (B) and at 24-h follow-up (C) differs substantially from that seen in Figure 1. The coronary flow velocity pattern showed an increase in the average peak flow velocity (ASPV) from 10 cm/s immediately after revascularization to 22 cm/s at 24-h follow-up. DDT = diastolic deceleration time; DSVR = diastolic-systolic velocity ratio.