| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
|
|
|
||||||||
|
||||||||||
Clinical Investigations |
1 Deutsches Herzzentrum München, Munich, Germany
2 Klinik und Poliklinik für Nuklearmedizin rechts der Isar Technische Universität, Munich, Germany
3 Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany
In patients with acute myocardial infarction (AMI) before primary coronary stenting with adjunct glycoprotein IIb/IIIa receptor blockade, whether residual blood flow in the infarct-related artery (IRA) affects infarct size or myocardial salvage is not known. Methods: This study included 118 patients with ST-segment elevation AMI who received coronary stenting plus abciximab. SPECT studies were performed before and 7–14 d after stenting. Results: Patients were divided into a group with initial Thrombolysis in Myocardial Infarction (TIMI) flow grade 
1 (77 patients) and a group with initial TIMI flow grade > 1 (41 patients). The initial median perfusion defect and (in brackets) the 25th and 75th percentiles were 29.1% [21.0%; 52.0%] of the left ventricle in patients with TIMI flow grade 1, versus 16.5% [8.0%; 33.1%] of the left ventricle in patients with TIMI flow grade > 1 (P < 0.001). Baseline left ventricular ejection fraction (54.0% [45.0; 63.0] vs. 57.0% [40.0; 62.0], P = 0.623) or extension of hypokinetic region (28.0 [14.0; 41.0] hypokinetic chords vs. 24.0 [13.0; 39.0] hypokinetic chords, P = 0.643) did not differ significantly between the group with TIMI flow grade 1 and the group with TIMI flow grade > 1. Final infarct size was 11.0% [6.1%; 23.5%] of the left ventricle in the group with TIMI flow grade 1, versus 6.0% [2.0%; 12.8%] of the left ventricle in the group with TIMI flow > 1 (P = 0.008). Salvage index was 0.58 [0.38; 0.76] in the group with TIMI flow grade 1, versus 0.61 [0.36; 0.74] in the group with TIMI flow grade > 1 (P = 0.952). At the day 14 angiography, patients with TIMI flow grade > 1 had better left ventricular ejection fraction (61.0% [54.0%; 68.0%] vs. 56.5% [42.9%; 65.0%]; P = 0.03) and a smaller hypokinetic region (7 chords [0; 22.0] vs. 16 chords [2.5; 30.0]; P = 0.024) than did patients with TIMI flow grade 1. Conclusion: Preserved blood flow in the IRA in patients with AMI is associated with a smaller area at risk, a smaller infarct, and better recovery of regional and global left ventricular function. The proportion of initial area at risk salvaged by coronary stenting does not seem to depend on residual blood flow in the IRA.
Key Words: coronary blood flow • myocardial infarction • scintigraphy • stents
Related articles in JNM:
This article has been cited by other articles:
|
|
 |
|
  G. Ndrepepa, J. Mehilli, S. Schulz, R. Iijima, D. Keta, R. A. Byrne, J. Pache, M. Seyfarth, A. Schomig, and A. Kastrati Prognostic Significance of Epicardial Blood Flow Before and After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndromes J. Am. Coll. Cardiol., August 12, 2008; 52(7): 512 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Thiele, M. J. Kappl, A. Linke, S. Erbs, E. Boudriot, A. Lembcke, D. Kivelitz, and G. Schuler Influence of time-to-treatment, TIMI-flow grades, and ST-segment resolution on infarct size and infarct transmurality as assessed by delayed enhancement magnetic resonance imaging Eur. Heart J., June 6, 2007; (2007) ehm173v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, G. Ndrepepa, and A. Kastrati Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction Eur. Heart J., August 2, 2006; 27(16): 1900 - 1907. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G De Luca, H Suryapranata, and M Chiariello Aspiration thrombectomy and primary percutaneous coronary intervention Heart, July 1, 2006; 92(7): 867 - 869. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
