BACKGROUND: The exact relationship between the coronary flow reserve (CFR) and infarct size remains unknown. In this prospective study the relationship between the CFR both in the infarcted and remote myocardium and infarct size was investigated. Furthermore, the diagnostic value of the CFR to predict the extent of microvascular obstruction (MO) was evaluated. METHODS: In thirty patients the CFR was measured with a Doppler guide wire 6 ± 3 days after a first myocardial infarction (MI) in the infarct related and in a reference coronary artery. MO and infarct size were determined with magnetic resonance imaging. RESULTS: The CFR was inversely related to infarct size in the infarcted and remote myocardium (respectively, r=-0.60, p<0.01 and r=-0.62, p<0.01). In the infarcted myocardium the extent of MO was strongly related to the infarct size and was in a multivariate analysis the single significant determinant of the CFR and the hyperaemic flow. In the remote myocardium no relationship was present between infarct size and hyperaemic flow, but the baseline flow increased as the infarct size became larger (r=0.58, p<0.01). In a receiver operator characteristic (ROC) analysis, a CFR value ≤ 2 in the infarct related coronary artery offered the best sensitivity (65%) and specificity (71%) to detect the presence of MO (p<0.05). CONCLUSIONS: After MI, the CFR both in the infarcted and remote myocardium is inversely related to infarct size. In the infarcted myocardium, a CFR value ≤ 2 predicts the presence of MO with moderate sensitivity and specificity.
BACKGROUND: The exact relationship between the coronary flow reserve (CFR) and infarct size remains unknown. In this prospective study the relationship between the CFR both in the infarcted and remote myocardium and infarct size was investigated. Furthermore, the diagnostic value of the CFR to predict the extent of microvascular obstruction (MO) was evaluated. METHODS: In thirty patients the CFR was measured with a Doppler guide wire 6 ± 3 days after a first myocardial infarction (MI) in the infarct related and in a reference coronary artery. MO and infarct size were determined with magnetic resonance imaging. RESULTS: The CFR was inversely related to infarct size in the infarcted and remote myocardium (respectively, r=-0.60, p<0.01 and r=-0.62, p<0.01). In the infarcted myocardium the extent of MO was strongly related to the infarct size and was in a multivariate analysis the single significant determinant of the CFR and the hyperaemic flow. In the remote myocardium no relationship was present between infarct size and hyperaemic flow, but the baseline flow increased as the infarct size became larger (r=0.58, p<0.01). In a receiver operator characteristic (ROC) analysis, a CFR value ≤ 2 in the infarct related coronary artery offered the best sensitivity (65%) and specificity (71%) to detect the presence of MO (p<0.05). CONCLUSIONS: After MI, the CFR both in the infarcted and remote myocardium is inversely related to infarct size. In the infarcted myocardium, a CFR value ≤ 2 predicts the presence of MO with moderate sensitivity and specificity.
Authors: Risto Kerkelä; Sara Karsikas; Zoltan Szabo; Raisa Serpi; Johanna Magga; Erhe Gao; Kari Alitalo; Andrey Anisimov; Raija Sormunen; Ilkka Pietilä; Laura Vainio; Walter J Koch; Kari I Kivirikko; Johanna Myllyharju; Peppi Koivunen Journal: Mol Cell Biol Date: 2013-06-17 Impact factor: 4.272
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Authors: Hernán Mejía-Rentería; Joo Myung Lee; Nina W van der Hoeven; Nieves Gonzalo; Pilar Jiménez-Quevedo; Luis Nombela-Franco; Iván J Núñez-Gil; Pablo Salinas; María Del Trigo; Enrico Cerrato; Niels van Royen; Paul Knaapen; Bon-Kwon Koo; Carlos Macaya; Antonio Fernández-Ortiz; Javier Escaned Journal: J Am Heart Assoc Date: 2019-05-07 Impact factor: 5.501
Authors: Annette M Maznyczka; Keith G Oldroyd; John P Greenwood; Peter J McCartney; James Cotton; Mitchell Lindsay; Margaret McEntegart; J Paul Rocchiccioli; Richard Good; Keith Robertson; Hany Eteiba; Stuart Watkins; Aadil Shaukat; Colin J Petrie; Aengus Murphy; Mark C Petrie; Colin Berry Journal: Circ Cardiovasc Interv Date: 2020-05-15 Impact factor: 6.546
Authors: Annette M Maznyczka; Peter J McCartney; Keith G Oldroyd; Mitchell Lindsay; Margaret McEntegart; Hany Eteiba; Paul Rocchiccioli; Richard Good; Aadil Shaukat; Keith Robertson; Vivek Kodoth; John P Greenwood; James M Cotton; Stuart Hood; Stuart Watkins; Peter W Macfarlane; Julie Kennedy; R Campbell Tait; Paul Welsh; Naveed Sattar; Damien Collison; Lynsey Gillespie; Alex McConnachie; Colin Berry Journal: J Am Heart Assoc Date: 2020-01-28 Impact factor: 5.501