Comparison between Microvascular Integrity Indexes Assessed by Pressure/Doppler Wire and %FDG Uptake in AMI following Primary PCI.
10.4070/kcj.2006.36.10.701
- Author:
Myeong Ho YOON
1
;
Seung Jea TAHK
;
So Yeon CHOI
;
Byoung Joo CHOI
;
Dai Yeol JOE
;
Bo Ram KOH
;
Hong Seok LIM
;
Soung Iil WOO
;
Jung Won WHANG
;
Jung Hyun CHOI
;
Zhen Guo ZHENG
;
Soo Jin KANG
;
Gyo Seung HWANG
;
Joon Han SHIN
Author Information
1. Department of Cardiology, School of Medicine, Ajou University, Suwon, Korea. sjtahk@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Microvasculation;
Positron-emission tomography;
Viability
- MeSH:
Area Under Curve;
DDT;
Deceleration;
Fluorodeoxyglucose F18;
Hemodynamics;
Humans;
Male;
Myocardial Infarction;
Myocardium;
Perfusion;
Positron-Emission Tomography;
Pulmonary Wedge Pressure
- From:Korean Circulation Journal
2006;36(10):701-709
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES : Microvascular integrity has been associated with the clinical outcomes in acute myocardial infarction (AMI). The present study was conducted to determine the value of many microvascular indexes assessed by an intracoronary (IC) pressure/Doppler wire in AMI following primary PCI for detecting viable myocardium by comparing with the 18F-fluorodeoxyglucose uptake rate (%FDG uptake) on positron-emission tomography (PET). SUBJECTS AND METHODS : We studied 35 patients who had their first AMI (age: 56+/-12, male: 30). After primary PCI, the TMPG (TIMI myocardial perfusion grade) was assessed. We measured the coronary flow reserve (CFR), the diastolic deceleration time (DDT), the coronary wedge pressure (Pcw), the Pcw/ Pa (mean aortic pressure) and the hyperemic microvascular resistance index (hMVRI) by an IC Doppler/ pressure wire. 18FDG PET scan was obtained at 7 days after the primary PCI; viable myocardium was defined that the %FDG uptake was more than 50% in infarct-related myocardium. RESULTS : There were significant correlations between TMPG, CFR, Pcw, Pcw/Pa, DDT, hMVRI and %FDG uptake (r=0.651, p<0.001; r=0.386, p=0.020; r=-0.388, p=0.021; r=-0.473, p=0.004; r=0.589, p<0.001; r=-0.442, p=0.008, respectively). The best cutoff values and area under curves (AUC) of the CFR, Pcw, Pcw/Pa, DDT and hMVRI for 50% FDG uptake were 1.8 (0.737), 27 mmHg (0.600), 0.33 (0.660), 600 msec (0.802) and 2.55 mmHg.cm-1.sec (0.768), respectively. The DDT had a significantly higher AUC than that of Pcw (p=0.029) and it was an independent index to predict the myocardial viability (p=0.011). CONCLUSION : DDT was the most reliable hemodynamic microvascular index that was assessed within 24 hours following primary PCI for predicting the viable myocardium in AMI patients.
