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Assessment of myocardial viability using coronary zero flow pressure after successful angioplasty in patients with acute anterior myocardial infarction
  1. K Shimada,
  2. Y Sakanoue,
  3. Y Kobayashi,
  4. S Ehara,
  5. M Hirose,
  6. Y Nakamura,
  7. D Fukuda,
  8. H Yamagishi,
  9. M Yoshiyama,
  10. K Takeuchi,
  11. J Yoshikawa
  1. Department of Internal Medicine and Cardiology Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan
  1. Correspondence to:
    Dr K Shimada, Department of Internal Medicine and Cardiology Graduate School of Medicine, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585 Japan;


Objectives: To investigate the relation between coronary flow reserve (CFR), coronary zero flow pressure (Pzf), and residual myocardial viability in patients with acute myocardial infarction.

Designs: Prospective study.

Setting: Primary care hospital.

Patients: 27 consecutive patients with acute anterior myocardial infarction.

Main outcome measures:18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) was used in 27 patients who underwent successful intervention within 12 hours of onset of a first acute anterior myocardial infarction. Within three days before discharge they had < 25% stenosis in the culprit lesion as determined by angiography 24 (3) days after acute myocardial infarction. Pzf and the slope index of the flow-pressure relation (SIFP) were calculated from the simultaneously recorded aortic pressure and coronary flow velocity signals at peak hyperaemia.%FDG was quantified by comparing FDG uptake in the infarct myocardium with FDG uptake in the normal myocardium.

Results: There was a correlation between %FDG and CFR, where y = −1.477x + 62.517, r = −0.072 (NS). There was also a correlation between %FDG and SIFP, where y = −0.975x + 60.542, r = −0.045 (NS), and a significant correlation between %FDG and Pzf, where y = −0.98x + 85.108, r = −0.696 (p < 0.001).

Conclusions: CFR does not correlate with FDG-PET at the time of postreperfusion evaluation of residual myocardial viability. The parameter that correlates best with residual myocardial viability is Pzf and this may be a useful index for predicting patient prognosis.

  • myocardial infarction
  • blood flow
  • pressure
  • myocardial viability
  • AMI, acute myocardial infarction
  • CFR, coronary flow reserve
  • FDG, 18F-fluorodeoxyglucose
  • PET, positron emission tomography
  • Pzf, zero flow pressure
  • SIFP, slope index of the flow-pressure relation
  • TIMI, thrombolysis in myocardial infarction

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