Assessing the relation between coronary reflow and myocardial reflow
Abstract
Since the recognition that prompt reperfusion of the infarct-related artery decreases mortality after acute myocardial infarction (MI), we have been interested in optimizing therapeutic regimens to accelerate the establishment of infarct-related artery patency. Although the major endpoint of many angiographic trials has been the acquisition of a patent infarct-related artery, this may not correlate with actual tissue perfusion because of the no-reflow phenomenon. With myocardial contrast echocardiography (MCE), we assessed the success of myocardial reperfusion at the microvascular level in patients with an acute anterior MI. We documented that 21% of the study patients exhibited Thrombolysis in Myocardial infarction (TIMI) grade 2 flow after coronary angioplasty, and all of them showed substantial "no reflow" on MCE. Conversely, no reflow was observed on MCE in only 16% of patients with TIMI grade 3 flow. Early TIMI grade 3 flow resulted in a significantly better left ventricular functional outcome compared with those with TIMI grade 2. In view of microvascular perfusion, TIMI grade 2, despite the absence of coronary obstruction, cannot be regarded as successful reperfusion. Our study, using a Doppler guidewire probe, documente...Continue Reading
References
Citations
Related Concepts
Related Feeds
Aphasia
Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.
Cardiovascular Diseases: Risk Factors
Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.