CARDIOVASCULAR MEDICINE

Can coronary flow velocity reserve determined by transthoracic Doppler echocardiography predict the recovery of regional left ventricular function in patients with acute myocardial infarction?

Y Ueno¹, Y Nakamura¹, M Kinoshita¹, T Fujita², T Sakamoto², H Okamura²

¹ The First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan
² Okamura Memorial Hospital, Shimizu, Japan

Correspondence to:
Correspondence to:
Dr Yoshiki Ueno, The First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Otsu, Shiga, 520–2192, Japan;
uenoy{at}belle.shiga-med.ac.jp

Objective: To determine whether the early assessment of coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) can predict myocardial viability after revascularisation in patients with acute myocardial infarction.

Methods: 29 patients with anterior acute myocardial infarction who were successfully treated by coronary angioplasty were studied. TTDE was used to record coronary flow velocities in the distal left anterior descending artery at rest and during hyperaemia induced by intravenous infusion of adenosine triphosphate. CFVR was calculated immediately and 24 hours after revascularisation and at discharge. Regional wall motion was analysed to calculate the anterior wall motion score index (A-WMSI) by two dimensional echocardiography before revascularisation and at discharge.

Results: CFVR immediately and 24 hours after revascularisation correlated significantly with A-WMSI at discharge (r = -0.58, p < 0.001 and r = -0.80, p < 0.0001, respectively). CFVR 24 hours after revascularisation was a better predictor of recovery of regional left ventricular function than CFVR immediately after revascularisation. The optimal cut off ratio for predicting viable myocardium was 1.5 for CFVR 24 hours after revascularisation (sensitivity = 94%, specificity = 91%).

Conclusions: CFVR by TTDE was useful for predicting the recovery of left ventricular function after revascularisation in patients with acute myocardial infarction

Keywords: coronary flow velocity reserve; transthoracic Doppler echocardiography; regional left ventricular function

Abbreviations: A-WMSI, anterior wall motion score index; CFVR, coronary flow velocity reserve; TIMI, thrombolysis in myocardial infarction; TTDE transthoracic Doppler echocardiography

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

This article has been cited by other articles:

• Mollema, S A, Nucifora, G, Bax, J J (2009). Prognostic value of echocardiography after acute myocardial infarction. Heart 95: 1732-1745 [Abstract] [Full Text]  
• Meimoun, P., Tribouilloy, C. (2008). Non-invasive assessment of coronary flow and coronary flow reserve by transthoracic Doppler echocardiography: a magic tool for the real world. Eur J Echocardiogr 9: 449-457 [Abstract] [Full Text]  
• Montisci, R, Chen, L, Ruscazio, M, Colonna, P, Cadeddu, C, Caiati, C, Montisci, M, Meloni, L, Iliceto, S (2006). Non-invasive coronary flow reserve is correlated with microvascular integrity and myocardial viability after primary angioplasty in acute myocardial infarction. Heart 92: 1113-1118 [Abstract] [Full Text]  
• Voci, P., Pizzuto, F., Romeo, F. (2004). Coronary flow: a new asset for the echo lab?. Eur Heart J 25: 1867-1879 [Full Text]