Circulation, Vol 85, 1699-1705, Copyright © 1992 by American Heart Association
H Ito, T Tomooka, N Sakai, H Yu, Y Higashino, K Fujii, T Masuyama, A Kitabatake and T Minamino
BACKGROUND. We investigated myocardial perfusion dynamics after
thrombolysis and its clinical implications. METHODS AND RESULTS. We studied
39 patients with acute anterior myocardial infarction (AMI). Myocardial
contrast echocardiography (MCE) was performed before and immediately after
successful reflow with intracoronary injection of sonicated Ioxaglate. The
average segmental score by two-dimensional echocardiography (graded 0,
normal, to 3, akinetic/dyskinetic) and global ejection fraction (left
ventricular ejection fraction, LVEF%) by left ventriculography were
measured at 1 day and at 4 weeks after reflow. Hypokinesis in the infarct
region was assessed by the centerline method and expressed in terms of
standard deviations (regional wall motion [RWM]: SD/chord) of normal.
Immediately after reflow, 30 of 39 patients (group A) showed significant
contrast enhancement within the risk area. The other nine patients (23%,
group B), however, showed the residual contrast defect in the risk area
(myocardial no reflow). There were no significant differences in the
elapsed time, angiographic collateral grade, and degree of residual
stenosis between group A and group B. Before reflow, both groups exhibited
similar levels of global and regional left ventricular function.
Improvement in global (LVEF, average segmental score) and regional left
ventricular function was greater in group A than in group B (average
segmental score, 0.44 +/- 0.41 versus 0.97 +/- 0.36, p less than 0.01;
LVEF, 56.4 +/- 13.4 versus 42.7 +/- 8.9, p less than 0.05; RWM, -1.87 +/-
0.85 versus -3.18 +/- 0.52, p less than 0.005). CONCLUSIONS. MCE
demonstrates that angiographically successful reflow cannot be used as an
indicator of successful myocardial reperfusion in AMI patients. The
residual contrast defect in the risk area demonstrated immediately after
reflow is a predictor of poor functional recovery of the postischemic
myocardium.
ARTICLES
Lack of myocardial perfusion immediately after successful thrombolysis. A predictor of poor recovery of left ventricular function in anterior myocardial infarction
Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
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R Senior Role of myocardial contrast echocardiography in the clinical evaluation of acute myocardial infarction Heart, December 1, 2003; 89(12): 1398 - 1400. [Full Text] [PDF]
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M. Nishino, H.-J. Youn, D. Gheorghevici, C. Zellner, T. M. Chou, K. Sudhir, and R. F. Redberg Effect of Intracoronary Estradiol on Postischemic Microvascular Damage in a Porcine Model: A Myocardial Contrast Echocardiographic Study Angiology, November 1, 2003; 54(6): 701 - 709. [Abstract] [PDF]
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M. Napodano, G. Pasquetto, S. Sacca, C. Cernetti, V. Scarabeo, P. Pascotto, and B. Reimers Intracoronary thrombectomy improves myocardial reperfusion in patients undergoing direct angioplasty for acute myocardial infarction J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1395 - 1402. [Abstract] [Full Text] [PDF]
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R Hoffmann, P Haager, W Lepper, A Franke, and P Hanrath Relation of coronary flow pattern to myocardial blush grade in patients with first acute myocardial infarction Heart, October 1, 2003; 89(10): 1147 - 1151. [Abstract] [Full Text] [PDF]
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T Hozumi, Y Kanzaki, Y Ueda, A Yamamuro, T Takagi, T Akasaka, S Homma, K Yoshida, and J Yoshikawa Coronary flow velocity analysis during short term follow up after coronary reperfusion: use of transthoracic Doppler echocardiography to predict regional wall motion recovery in patients with acute myocardial infarction Heart, October 1, 2003; 89(10): 1163 - 1168. [Abstract] [Full Text] [PDF]
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R Erbel Spontaneous and interventional coronary microembolisation Heart, September 1, 2003; 89(9): 986 - 989. [Full Text] [PDF]
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C. M. Gibson Has My Patient Achieved Adequate Myocardial Reperfusion? Circulation, August 5, 2003; 108(5): 504 - 507. [Full Text] [PDF]
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L A Pierard Assessing perfusion and function in acute myocardial infarction: how and when? Heart, July 1, 2003; 89(7): 701 - 703. [Full Text] [PDF]
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L Galiuto, A Lombardo, A Maseri, L Santoro, I Porto, D Cianflone, A G Rebuzzi, and F Crea Temporal evolution and functional outcome of no reflow: sustained and spontaneously reversible patterns following successful coronary recanalisation Heart, July 1, 2003; 89(7): 731 - 737. [Abstract] [Full Text] [PDF]
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W. F. Fearon, L. B. Balsam, H. M. O. Farouque, R. C. Robbins, P. J. Fitzgerald, P. G. Yock, and A. C. Yeung Novel Index for Invasively Assessing the Coronary Microcirculation Circulation, July 1, 2003; 107(25): 3129 - 3132. [Abstract] [Full Text] [PDF]
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A.F.L Schinkel, J.J Bax, M.L Geleijnse, E Boersma, A Elhendy, J.R.T.C Roelandt, and D Poldermans Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echocardiography? Eur. Heart J., May 1, 2003; 24(9): 789 - 800. [Full Text] [PDF]
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Y Nohtomi, M Takeuchi, K Nagasawa, K Arimura, K Miyata, K Kuwata, T Yamawaki, S Kondo, A Yamada, and S Okamatsu Persistence of systolic coronary flow reversal predicts irreversible dysfunction after reperfused anterior myocardial infarction Heart, April 1, 2003; 89(4): 382 - 388. [Abstract] [Full Text] [PDF]
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P Garot, O Pascal, M Simon, J L Monin, E Teiger, J Garot, P Gueret, and J L Dubois-Rande Impact of microvascular integrity and local viability on left ventricular remodelling after reperfused acute myocardial infarction Heart, April 1, 2003; 89(4): 393 - 397. [Abstract] [Full Text] [PDF]
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E. Balcells, E. R. Powers, W. Lepper, T. Belcik, K. Wei, M. Ragosta, H. Samady, and J. R. Lindner Detection of myocardial viability by contrast echocardiography in acute infarction predicts recovery of resting function and contractile reserve J. Am. Coll. Cardiol., March 5, 2003; 41(5): 827 - 833. [Abstract] [Full Text] [PDF]
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P. K. Haager, P. Christott, N. Heussen, W. Lepper, P. Hanrath, and R. Hoffmann Prediction of clinical outcome after mechanical revascularization in acute myocardial infarction by markers of myocardial reperfusion J. Am. Coll. Cardiol., February 19, 2003; 41(4): 532 - 538. [Abstract] [Full Text] [PDF]
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P. Johanson, T. Jernberg, G. Gunnarsson, B. Lindahl, L. Wallentin, and M. Dellborg Prognostic value of ST-segment resolution--when and what to measure Eur. Heart J., February 2, 2003; 24(4): 337 - 345. [Abstract] [Full Text] [PDF]
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K Greaves, S R Dixon, M Fejka, W W O'Neill, S R Redwood, M S Marber, and R Senior Myocardial contrast echocardiography is superior to other known modalities for assessing myocardial reperfusion after acute myocardial infarction Heart, February 1, 2003; 89(2): 139 - 144. [Abstract] [Full Text] [PDF]
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T Muro, T Hozumi, H Watanabe, H Yamagishi, M Yoshiyama, K Takeuchi, and J Yoshikawa Assessment of myocardial perfusion abnormalities by intravenous myocardial contrast echocardiography with harmonic power Doppler imaging: comparison with positron emission tomography Heart, February 1, 2003; 89(2): 145 - 149. [Abstract] [Full Text] [PDF]
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K.M.J. Marques and C.A. Visser Myocardial contrast echocardiography in the assessment of pharmacologic intervention of the reperfusion injury Eur. Heart J., January 1, 2003; 24(1): 19 - 20. [Full Text] [PDF]
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The Task Force on the Management of Acute Myocardi, F. Van de Werf, D. Ardissino, A. Betriu, D. V. Cokkinos, E. Falk, K. A.A. Fox, D. Julian, M. Lengyel, F.-J. Neumann, et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation Eur. Heart J., January 1, 2003; 24(1): 28 - 66. [Full Text] [PDF]
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A.S Petronio, D Rovai, G Musumeci, R Baglini, C Nardi, U Limbruno, C Palagi, D Volterrani, and M Mariani Effects of abciximab on microvascular integrity and left ventricular functional recovery in patients with acute infarction treated by primary coronary angioplasty Eur. Heart J., January 1, 2003; 24(1): 67 - 76. [Abstract] [Full Text] [PDF]
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K. Iwakura, H. Ito, M. Ikushima, S. Kawano, A. Okamura, K. Asano, T. Kuroda, K. Tanaka, T. Masuyama, M. Hori, et al. Association between hyperglycemia and the no-reflow phenomenon inpatients with acute myocardial infarction J. Am. Coll. Cardiol., January 1, 2003; 41(1): 1 - 7. [Abstract] [Full Text] [PDF]
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A. Yamamuro, T. Akasaka, K. Tamita, K. Yamabe, M. Katayama, T. Takagi, and S. Morioka Coronary Flow Velocity Pattern Immediately After Percutaneous Coronary Intervention as a Predictor of Complications and In-Hospital Survival After Acute Myocardial Infarction Circulation, December 10, 2002; 106(24): 3051 - 3056. [Abstract] [Full Text] [PDF]
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K. Yamamoto, H. Ito, K. Iwakura, S. Kawano, M. Ikushima, T. Masuyama, T. Ogihara, and K. Fujii Two different coronary blood flow velocity patterns in thrombolysis in myocardial infarction flow grade 2 in acute myocardial infarction: Insight into mechanisms of microvascular dysfunction J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1755 - 1760. [Abstract] [Full Text] [PDF]
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G. A. Krombach, M. F. Wendland, C. B. Higgins, and M. Saeed MR Imaging of Spatial Extent of Microvascular Injury in Reperfused Ischemically Injured Rat Myocardium: Value of Blood Pool Ultrasmall Superparamagnetic Particles of Iron Oxide Radiology, November 1, 2002; 225(2): 479 - 486. [Abstract] [Full Text] [PDF]
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