OBJECTIVE: To study whether flow velocity profile in the left anterior descending coronary artery (LAD) measured by transthoracic Doppler echocardiography (TTDE) predicts myocardial viability after reperfused anterior acute myocardial infarction (AMI). PATIENTS AND METHODS: 15 patients who had their first anterior ST elevation AMI and were successfully reperfused by coronary angioplasty and five controls without coronary artery disease were selected. Blood flow velocity spectrum was measured from the mid-LAD by TTDE 3 days after coronary angioplasty. Myocardial viability in the LAD region was quantified 3 months after AMI by relative uptake of 18F-fluorodeoxyglucose (FDG) imaged with positron emission tomography. Myocardium was graded as viable, partially viable or non-viable (relative FDG uptake >85%, 67-85% and <67%, respectively). Main outcome measures were diastolic deceleration time (DDT) of LAD flow velocity 3 days after AMI and myocardial viability 3 months after AMI. RESULTS: DDT of LAD flow velocity correlated with myocardial FDG uptake in the LAD region (r = 0.91, p<0.01). DDT was markedly longer in patients with viable myocardium (876+/-76 ms, n = 3) than partially viable (356+/-89 ms, n = 6, p<0.01), or non-viable myocardium (128+/-13 ms, n = 6, p<0.01). In controls, DDT was comparable (909+/-76 ms, n = 5) to patients with viable myocardium. DDT <190 ms was always associated with non-viable myocardium. CONCLUSIONS: DDT of LAD flow velocity is strongly associated with myocardial viability after reperfused anterior AMI. Non-invasive TTDE of the LAD may be used in the acute phase to predict long-term viability of the jeopardised myocardium.
OBJECTIVE: To study whether flow velocity profile in the left anterior descending coronary artery (LAD) measured by transthoracic Doppler echocardiography (TTDE) predicts myocardial viability after reperfused anterior acute myocardial infarction (AMI). PATIENTS AND METHODS: 15 patients who had their first anterior ST elevation AMI and were successfully reperfused by coronary angioplasty and five controls without coronary artery disease were selected. Blood flow velocity spectrum was measured from the mid-LAD by TTDE 3 days after coronary angioplasty. Myocardial viability in the LAD region was quantified 3 months after AMI by relative uptake of 18F-fluorodeoxyglucose (FDG) imaged with positron emission tomography. Myocardium was graded as viable, partially viable or non-viable (relative FDG uptake >85%, 67-85% and <67%, respectively). Main outcome measures were diastolic deceleration time (DDT) of LAD flow velocity 3 days after AMI and myocardial viability 3 months after AMI. RESULTS:DDT of LAD flow velocity correlated with myocardial FDG uptake in the LAD region (r = 0.91, p<0.01). DDT was markedly longer in patients with viable myocardium (876+/-76 ms, n = 3) than partially viable (356+/-89 ms, n = 6, p<0.01), or non-viable myocardium (128+/-13 ms, n = 6, p<0.01). In controls, DDT was comparable (909+/-76 ms, n = 5) to patients with viable myocardium. DDT <190 ms was always associated with non-viable myocardium. CONCLUSIONS:DDT of LAD flow velocity is strongly associated with myocardial viability after reperfused anterior AMI. Non-invasive TTDE of the LAD may be used in the acute phase to predict long-term viability of the jeopardised myocardium.
Authors: Paolo Voci; Enrica Mariano; Francesco Pizzuto; Paolo Emilio Puddu; Francesco Romeo Journal: J Am Coll Cardiol Date: 2002-10-02 Impact factor: 24.094
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Authors: K Iwakura; H Ito; S Takiuchi; Y Taniyama; Y Nakatsuchi; S Negoro; Y Higashino; A Okamura; T Masuyama; M Hori; K Fujii; T Minamino Journal: Circulation Date: 1996-09-15 Impact factor: 29.690
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Authors: Maija T Mäki; Juha W Koskenvuo; Heikki Ukkonen; Antti Saraste; Helena Tuunanen; Mikko Pietilä; Sergey V Nesterov; Ville Aalto; K E Juhani Airaksinen; Jussi P Pärkkä; Riikka Lautamäki; Kari Kervinen; Johanna A Miettinen; Timo H Mäkikallio; Matti Niemelä; Marjaana Säily; Pirjo Koistinen; Eeva-Riitta Savolainen; Kari Ylitalo; Heikki V Huikuri; Juhani Knuuti Journal: Front Physiol Date: 2012-01-30 Impact factor: 4.566
Authors: Markus Malmberg; Tommi Vähäsilta; Antti Saraste; Juha W Koskenvuo; Jussi P Pärkkä; Kari Leino; Timo Laitio; Christoffer Stark; Aira Heikkilä; Pekka Saukko; Timo Savunen Journal: Front Physiol Date: 2012-02-14 Impact factor: 4.566