Coronary Flow Velocity Pattern Assessed Noninvasively by Transthoracic Color Doppler Echocardiography Serves as a Predictor of Adverse Cardiac Events and Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

2006 ◽  
Vol 19 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Minako Katayama ◽  
Atsushi Yamamuro ◽  
Yoshiaki Ueda ◽  
Koichi Tamita ◽  
Kenji Yamabe ◽  
...  
Keyword(s):  
Coronary Flow ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Color Doppler ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Color Doppler Echocardiography ◽  
Coronary Flow Velocity ◽  
Velocity Pattern ◽  
Adverse Cardiac Events

Abstract 4910: Integrated Approach By Using Coronary Flow Velocity Reserve And Coronary Flow Velocity Patterns In Predicting Long-term Adverse Cardiac Events In Acute Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Myeong Ho Yoon ◽  
Seung-Jea Tahk ◽  
Hong-Seok Lim ◽  
Jin-Sun Park ◽  
Hyeong-Mo Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Integrated Approach ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Coronary Flow Velocity ◽  
Adverse Cardiac Events

Background: The microvascular function was known to be an useful predictor of left ventricular functional changes and clinical outcomes in ST-segment elevation myocardial infarction (STEMI). We evaluated the usefulness of integrated approach by using coronary flow velocity reserve (CFR) and diastolic deceleration time (DDT) in the prediction of long-term major adverse cardiac events in STEMI. Methods and Results: Using an intracoronary Doppler wire, CFR, DDT and hyperemic microvascular resistance index (MVRI) were evaluated in 202 patients with first STEMI received reperfusion therapy within 24 hours after onset of symptoms. Major adverse cardiac events were the composite of cardiac death, recurrent myocardial infarction, congestive heart failure and stroke during an average follow-up period of 60 ± 39 months. Follow-up echocardiography was performed at 12 ± 9 months. CFR, DDT and MVRI had significant correlations with left ventricular regional wall motion score index at follow-up echocardiography (r =−0.441, p<0.001; r = 0.413, p<0.001; r =−0.485, p<0.001, respectively). Using receiver-operating characteristics analysis, CFR ≤1.3 (sensitivity: 51%, specificity: 78%), DDT ≤577 ms (sensitivity: 72%, specificity: 62%) and MVRI >2.7 (sensitivity: 68%, specificity: 67%) were the best cutoff values in the prediction of occurring the adverse cardiac events. In patients with CFR ≤1.3, DDT ≤577 ms, cardiac events were occurred in 18 patients (40.0 %) of 45 patients, whereas cardiac events were occurred in 12 patients (20.3%) of 59 patients with CFR >1.3 and DDT ≤577 ms or CFR ≤1.3 and DDT >577 ms (p= 0.048), 9 patients (9.1%) of 99 patients with CFR>1.3 and DDT >577 ms (p<0.001). Ejection fraction at admission (p=0.009), MVRI (p =0.002) and DDT (p=0.023) were independent predictors in the prediction of long-term adverse cardiac outcomes during follow-up. Conclusions: Integrated approach by using CFR and DDT was useful in the prediction of long-term adverse cardiac events. MVRI and DDT were strong independent predictors of long-term adverse cardiac events in STEMI patients.

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