Abstract 18884: Coronary Flow Velocity Pattern After Primary Percutaneous Coronary Intervention as a Predictor of Transmural Extent of Infarction in Patients with St-segment Elevation Acute Myocardial Infarction
Purpose: The purpose of this study was to investigate whether coronary flow velocity pattern after primary percutaneous coronary intervention (PCI) can predict the transmural extent of infarction (TEI) defined by contrast-enhanced cardiac magnetic resonance (ce-CMR) in patients with acute myocardial infarction (MI).
Methods: In 91 patients after successful PCI for first acute MI, deceleration time of diastolic coronary flow velocity (DDT) were measured by transthoracic echocardiography. Ce-MRI were performed 7 days after onset of AMI. TEI was graded from 1 to 4 based on the transmural extent of hyperenhanced tissue (grade 1: 0-25% of left ventricular wall thickness, 2: 26-50%, 3: 51-75%, and 4: 76-100%). Infarct size by ce-CMR was also calculated.
Results: Adequate recording of DDT were obtained in 87 of 91 patients (96%). Infarct size by ce-CMR and peak creatine kinase-myocardial band values were significantly correlated with DDT (r=0.54, p <0.0001 and (r=0.40, p=0.006, respectively). Moreover, decreased DDT was significantly related to increased TEI-grade (p< 0.0001) (figure) and existence of microvascular obstruction (p<0.0001).
Conclusion: DDT measured after primary PCI is a useful predictor for the TEI in patients with acute MI.
- © 2012 by American Heart Association, Inc.