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Two different coronary blood flow velocity patterns in thrombolysis in myocardial infarction flow grade 2 in acute myocardial infarction

Insight into mechanisms of microvascular dysfunction

Koichi Yamamoto, MD^*, Hiroshi Ito, MD, FACC^*,*, Katsuomi Iwakura, MD^*, Shigeo Kawano, MD^*, Masashi Ikushima, MD^*, Tohru Masuyama, MD, FACC, Toshio Ogihara, MD and Kenshi Fujii, MD^*

^* Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan
Department of Internal Medicine and Therapeutics, Graduate School of Medicine, Osaka University, Osaka, Japan
Department of Geriatric Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan

View larger version (66K): [in a new window]   Figure 1 Coronary blood flow velocity patterns in patients with reperfused acute myocardial infarction with Thrombolysis In Myocardial Infarction flow grade 2 (TIMI-2 flow). These two patients showed TIMI-2 flow after a successful coronary intervention. (Left) Systolic flow reversal (SFR) is observed in systolic followed by rapid diastolic flow, with a steep deceleration slope. (Right) SRF is not observed. Very slow anterograde flow was found throughout one cardiac cycle. Diastolic flow deceleration was gentle.

View larger version (21K): [in a new window]   Figure 2 Distribution of the average peak velocity (APV) among the three subgroups: Thrombolysis In Myocardial Infarction flow grade 2 (TIMI-2 flow) and TIMI-2 flow with systolic flow reversal (SFR)(+) and without SFR(-). The APV was highest in the TIMI-3 group and comparable between the SFR(+) and SFR(-) groups (25.5 ± 11.8 vs. 13.8 ± 7.1 vs. 7.1 ± 3.6 cm/s [mean ± SD]).