Early prediction of myocardial salvage after primary coronary angioplasty: comparative study of coronary flow velocity pattern immediately after primary coronary angioplasty and perfusion-metabolism mismatch.

Abstract

OBJECTIVES:

Perfusion-metabolism mismatch in the subacute phase using thallium-201/radio iodinated beta-methyl-p-iodophenyl pentadecanoic acid (T1/BMIPP) dual scintigraphy is an indicator of viable myocardium in acute myocardial infarction. This study investigated early prediction of myocardial salvage from the T1/BMIPP mismatch and coronary flow velocity (CFV) patterns in patients with acute myocardial infarction.

METHODS:

Thirty three patients with first anterior wall myocardial infarction underwent primary coronary angioplasty and achieved reflow within 8 hr of onset. By using a Doppler guide wire, CFV patterns were assessed immediately after primary coronary angioplasty. T1/BMIPP dual scintigraphy was performed within 3 days after reperfusion. The extent of discordance in severity score was defined as the T1/BMIPP mismatch score.

RESULTS:

Regression analysis showed dual scintigraphy mismatch score correlated well with deceleration time of diastolic flow velocity (r = 0.54, p < 0.01). Mismatch score was greater in the non-early systolic reversal flow group than in the early systolic reversal flow group (5.5 +/- 3.3 vs 1.9 +/- 2.1, respectively, p < 0.01).

CONCLUSIONS:

Changes in CFV patterns correlated well with T1/BMIPP mismatch score. CFV pattern immediately after reperfusion is useful for early prediction of myocardial salvage.

• Authors: Naoki Suzuki, Yoshikazu Hiasa, Takefumi Takahashi, Hirotoshi Chen, Shinichiro Miyazaki, Keitaro Mahara, Hitoshi Miyajima, Riyo Ogura, Kenichiro Yuba, Shinobu Hosokawa, Koichi Kishi, Ryuji Otani
• Journal: Journal of cardiology (J Cardiol) Vol. 49 Issue 4 Pg. 163-70 (Apr 2007) ISSN: 0914-5087 [Print] Netherlands
• PMID: 17460876 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Fatty Acids
• Iodine Radioisotopes
• Iodobenzenes
• Thallium Radioisotopes
• iodofiltic acid

Topics

• Aged
• Angioplasty, Balloon, Coronary
• Blood Flow Velocity (physiology)
• Coronary Circulation (physiology)
• Fatty Acids
• Female
• Heart (diagnostic imaging)
• Humans
• Iodine Radioisotopes
• Iodobenzenes
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, physiopathology, therapy)
• Myocardial Reperfusion
• Myocardium (metabolism)
• Radionuclide Imaging
• Thallium Radioisotopes
• Ultrasonography, Doppler