Coronary Flow Reserve in the Remote Myocardium Predicts Left Ventricular Remodeling Following Acute Myocardial Infarction.
10.3349/ymj.2014.55.4.904
- Author:
Rongchao CHENG
1
;
Guoqian WEI
;
Longhao YU
;
Zhendong SU
;
Li WEI
;
Xiuping BAI
;
Jiawei TIAN
;
Xueqi LI
Author Information
1. Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China. lixueqi@ymail.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Myocardial infarction;
microvascular dysfunction;
left ventricular remodeling
- MeSH:
Aged;
Coronary Angiography;
Coronary Circulation/physiology;
Female;
Humans;
Male;
Middle Aged;
Myocardial Infarction/*physiopathology/radiography;
Myocardium/*pathology;
Ventricular Remodeling/*physiology
- From:Yonsei Medical Journal
2014;55(4):904-911
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. MATERIALS AND METHODS: We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. RESULTS: CFR was 1.55+/-0.11 in the infarcted zone and 2.05+/-0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. CONCLUSION: Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.
