Impaired coronary flow reserve immediately after coronary angioplasty in patients with acute myocardial infarction.

M Ishihara, H Sato, H Tateishi, T Kawagoe, M Yoshimura, Y Muraoka

Department of Cardiology, Hiroshima City Hospital, Japan.

OBJECTIVE--To examine coronary flow reserve immediately after emergency coronary angioplasty in patients with acute myocardial infarction. DESIGN--A 3 F coronary Doppler catheter was used to measure coronary blood flow velocity in the infarct artery and in the non-infarct artery. Maximal hyperaemia was produced by 10 mg of intracoronary papaverine and coronary flow reserve was calculated. PATIENTS--11 patients with acute myocardial infarction undergoing both emergency coronary angioplasty (4.7 (3.6) h after the onset of chest pain (mean (SD))) and at follow up catheterisation 16 (4) days after angioplasty. SETTING--Hiroshima City Hospital. RESULTS--There was no stenosis of > or = 50% in the coronary artery of interest. Immediately after coronary angioplasty the mean (1 SD) coronary flow reserve of the infarct artery was significantly less than that of the non-infarct artery (1.4 (0.4) v 2.8 (0.8), p < 0.001). At follow up catheterisation the coronary flow reserve of the infarct artery increased almost to the value of the non-infarct artery (2.8 (1.2) v 3.1 (0.8) p = NS). CONCLUSION--The coronary flow reserve in the infarct region was severely impaired immediately after reperfusion, even with a widely patent infarct artery. This could restrict the beneficial effects of reperfusion therapy, especially when there is a severe residual stenosis.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ueno, Y, Nakamura, Y, Kinoshita, M, Fujita, T, Sakamoto, T, Okamura, H (2002). Can coronary flow velocity reserve determined by transthoracic Doppler echocardiography predict the recovery of regional left ventricular function in patients with acute myocardial infarction?. Heart 88: 137-141 [Abstract] [Full Text]  
• Beran, G., Lang, I., Schreiber, W., Denk, S., Stefenelli, T., Syeda, B., Maurer, G., Glogar, D., Siostrzonek, P. (2002). Intracoronary Thrombectomy With the X-Sizer Catheter System Improves Epicardial Flow and Accelerates ST-Segment Resolution in Patients With Acute Coronary Syndrome: A Prospective, Randomized, Controlled Study. Circulation 105: 2355-2360 [Abstract] [Full Text]  
• Neumann, F.-J. (2001). Optimization of microvascular reperfusion in acute myocardial infarction. Eur Heart J Suppl 3: A21-A25 [Abstract]  
• Sasao, H, Tsuchihashi, K, Hase, M, Nakata, T, Shimamoto, K, investigators, t. N.-9. (2000). Does primary stenting preserve cardiac function in myocardial infarction? A case-control study. Heart 84: 515-521 [Abstract] [Full Text]  
• Bowers, T. R., O'Neill, W. W. (2000). Beyond TIMI III Flow. Circulation 101: 2332-2334 [Full Text]  
• Lepper, W., Hoffmann, R., Kamp, O., Franke, A., de Cock, C. C., Kuhl, H. P., Sieswerda, G. T., Dahl, J. v., Janssens, U., Voci, P., Visser, C. A., Hanrath, P. (2000). Assessment of Myocardial Reperfusion by Intravenous Myocardial Contrast Echocardiography and Coronary Flow Reserve After Primary Percutaneous Transluminal Coronary Angiography in Patients With Acute Myocardial Infarction. Circulation 101: 2368-2374 [Abstract] [Full Text]  
• Feldman, L. J., Himbert, D., Juliard, J.-M., Karrillon, G. J., Benamer, H., Aubry, P., Boudvillain, O., Seknadji, P., Faraggi, M., Steg, P. G. (2000). Reperfusion syndrome: relationship of coronary blood flow reserve to left ventricular function and infarct size. J Am Coll Cardiol 35: 1162-1169 [Abstract] [Full Text]  
• Brochet, E., Czitrom, D., Karila-Cohen, D., Seknadji, P., Faraggi, M., Benamer, H., Aubry, P., Steg, P. G., Assayag, P. (1998). Early changes in myocardial perfusion patterns after myocardial infarction: relation with contractile reserve and functional recovery. J Am Coll Cardiol 32: 2011-2017 [Abstract] [Full Text]  
• Kern, M. J., Moore, J. A., Aguirre, F. V., Bach, R. G., Caracciolo, E. A., Wolford, T., Khoury, A. F., Mechem, C., Donohue, T. J. (1996). Determination of Angiographic (TIMI Grade) Blood Flow by Intracoronary Doppler Flow Velocity During Acute Myocardial Infarction. Circulation 94: 1545-1552 [Abstract] [Full Text]  
• Neumann, F.-J., Ott, I., Gawaz, M., Richardt, G., Holzapfel, H., Jochum, M., Schomig, A. (1995). Cardiac Release of Cytokines and Inflammatory Responses in Acute Myocardial Infarction. Circulation 92: 748-755 [Abstract] [Full Text]