Coronary flow reserve is reflective of myocardial perfusion status in acute anterior myocardial

Do Sun Lim, Young Hoon Kim, Hyun Soo Lee, Chang Gyu Park, Hong G. Seo, Wan Joo Shim, Dong Joo Oh, Young Moo Ro

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Our objective was to determine whether coronary vasodilatory reserve (CVR) correlates with the perfusion state of infarct zone in early recovery phase of acute anterior myocardial infarction (AMI). We studied 14 patients (11 males; mean age, 48 years) who had AMI and 8 control subjects who had chest pain but normal coronary angiograms. All patients underwent successful percutaneous revascularization of left anterior descending (LAD) coronary artery. Coronary flow velocity was measured using intracoronary (IC) Doppler at baseline and following IC injection of 18 μg of adenosine. Myocardial perfusion was evaluated by myocardial contrast echocardiography (MCE). CVR was higher in patients without a perfusion defect on MCE than in those with (2.48 ± 0.21 vs. 1.66 ± 0.13, P = 0.001). Subjects with a perfusion defect had a lower CVR than controls (1.66 ± 0.13 vs.2.40 ± 0.18, P < 0.05). CVR was > 2.0 in all subjects without a perfusion defect. There was a strong correlation between the magnitude of myocardial opacification in the LAD territory and CVR (r = 0.80, P < 0.01). Increase in peak diastolic flow velocity after adenosine infusion, but not systolic flow velocity, correlated with myocardial opacification index (r = 0.63, P = 0.016). CVR of infarct-related artery correlated closely with the perfusion status of the myocardium in infarct zone and those with a CVR > 2.0 had normal myocardial perfusion. These data suggest that CVR may be used to determine the perfusion state of the myocardium in the infarct zone, which is a known predictor of myocardial viability. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish
Pages (from-to)281-286
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume51
Issue number3
DOIs
Publication statusPublished - 2000

Keywords

  • Acute myocardial infarction
  • Coronary vasodilatory reserve
  • Myocardial contrast echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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