Recovery of global systolic function after primary angioplasty. Influence of coronary flow velocity reserve measured by transthoracic echocardiography.

Autor: Florenciano-Sánchez R; Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, 30120 El Palmar, Murcia, Spain. r_florenciano@hotmail.com, Rubio-Patón R, de la Morena-Valenzuela G, Antolinos MJ, Cerdán MC, Espinosa MD, Soria-Arcos F, Saura-Espín D, Valdés Chávarri M
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2007 Jan 18; Vol. 114 (3), pp. 315-22. Date of Electronic Publication: 2006 Aug 04.
DOI: 10.1016/j.ijcard.2006.01.020
Abstrakt: Background: Our objective were to know whether coronary flow velocity reserve measured by transthoracic Doppler echocardiography, as marker of microvascular integrity, affects the recovery of global systolic function. Secondly, we intended to define the best cut-off point of coronary flow velocity reserve to predict recovery of global systolic function.
Methods: We studied 57 patients with coronary flow recorded by transthoracic Doppler echocardiography, after suffering a first anterior acute myocardial infarction and undergoing a successful primary percutaneous coronary intervention (TIMI 3 flow). We measured, at discharge and at 1 month: ejection fraction, volume indexes and anterior wall motion score index. Coronary flow in left anterior descending artery was detected by transthoracic Doppler echocardiography and coronary flow velocity reserve was calculated.
Results: After applying ROC curves, 1.54 was the best cut-off value of coronary flow velocity reserve for detection of recovery of global systolic function. Ejection fraction only increased significantly in patients with normal coronary flow velocity reserve. Only end-systolic volume index increased significantly at 1 month in patients with impaired coronary flow velocity reserve.
Conclusion: We showed that coronary flow velocity reserve, measured by transthoracic Doppler echocardiography, influence the recovery of global systolic function, mainly by ventricular dilation. Furthermore, a quite lower value of coronary flow velocity reserve than that used for diagnostic purpose should be used to predict improvement of systolic function.
Databáze: MEDLINE
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