scholarly journals 622 Noninvasive assessment of coronary flow reserve after elective stenting in patients with previous myocardial infarction: Relation to left ventricular recovery

2006 ◽  
Vol 7 ◽  
pp. S94-S94
Author(s):  
A DJORDJEVICDIKIC ◽  
M OSTOJIC ◽  
B BELESLIN ◽  
J STEPANOVIC ◽  
V GIGA ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Previous Myocardial Infarction ◽  
Flow Reserve ◽  
Left Ventricular Recovery ◽  
Noninvasive Assessment

Abstract 3339: Effects of Atorvastatin 10 mg versus 40 mg in Eight Months Follow-up Coronary Flow Reserve and Clinical Events in Patients with Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Soon Jun Hong ◽  
Seung Cheol Choi ◽  
Jong Il Choi ◽  
Hyung Joon Joo ◽  
Seung Yong Shin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Systolic Function ◽  
Left Ventricular ◽  
Clinical Events ◽  
Flow Reserve ◽  
Cd34 Cells

Background: Circulating bone marrow-derived stem cells are capable of homing to sites of myocardial infarction and endothelial disruption, thereby restoring myocardial function and microvascular integrity after acute myocardial infarction. We compared the effects of atorvastatin 10 mg versus 40 mg in follow-up clinical events and in restoring coronary flow reserve (CFR) during the 8 months follow-up in patients with acute myocardial infarction. Methods: CFR, which is reflective of the integrity of coronary microvasculature, was measured by using intracoronary Doppler wire in 102 consecutive patients with acute myocardial infarction 5 days after the successful primary coronary intervention with sirolimus-eluting stents. Stented patients were randomly assigned to either atorvastatin 10 mg (ATOR10, n=52) or atorvastatin 40 mg (ATOR40, n=50). All patients received aspirin and clopidogrel. Clinical events such as death, myocardial infarction, and target lesion revascularization (TLR) were compared during the 8-month follow-up. Results: CFR increased significantly in both groups during the 8 months follow-up (1.9 ± 0.6 at baseline vs. 2.6 ± 0.7 at follow-up in the ATOR10, p<0.05; 1.9 ± 0.7 at baseline vs. 2.9 ± 0.8 at follow-up in the ATOR40, p<0.05). The changes from baseline in CFR was greater in the ATOR40 Group compared with the ATOR10 Group (1.0 ± 0.8 vs. 0.7 ± 0.6, p<0.05, respectively). The numbers of CD34+ and CXCR4+ cells were significantly greater in the ATOR40 Group compared with the ATOR10 Group (13 ± 10 vs. 6 ± 6, p<0.05, respectively for CD34 cells and 15 ± 14 vs. 10 ± 9, p<0.05, respectively for CXCR4+ cells per 1uL). Clinical events such as death (0 patient in the ATOR10 vs. 2 patients in the ATOR40, p=0.247), myocardial infarction (2 patients in the ATOR10 vs. 1 patient in the ATOR40, p=0.557), and TLR (2 patients in the ATOR10 vs. 2 patients in the ATOR40, p=0.692) demonstrated no significant differences during the follow-up. Conclusion: The increases from baseline in CFR, CD34+ cells and CXCR4+ cells were significantly greater in the ATOR40 Group compared with the ATOR10 Group. However, the improvement in left ventricular systolic function and the rate of clinical events revealed no significant differences between the 2 groups.

scholarly journals The value of fractional and coronary flow reserve in predicting myocardial recovery in patients with previous myocardial infarction

2008 ◽  
Vol 29 (21) ◽  
pp. 2617-2624 ◽  
Author(s):  
B. Beleslin ◽  
M. Ostojic ◽  
A. Djordjevic-Dikic ◽  
V. Vukcevic ◽  
S. Stojkovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Myocardial Recovery ◽  
Previous Myocardial Infarction ◽  
Flow Reserve

Abstract 3336: Fractional and Coronary Flow Reserve in Prediction of Functional Recovery of Myocardium in Patients with Previous Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Branko Beleslin ◽  
Miodrag Ostojic ◽  
Ana Djordjevic-Dikic ◽  
Vladan Vukcevic ◽  
Sinisa Stojkovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Functional Recovery ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Functional Improvement ◽  
Lv Function ◽  
Previous Myocardial Infarction ◽  
Flow Reserve ◽  
Lv Ejection Fraction

Background: Fractional flow reserve (FFR) may provide clinically useful diagnostic information both in patients (pts) with normal left ventricular (LV) function as well as in pts with previous myocardial infarction (MI). However, the question remains to the relation between improvement of FFR and improvement of LV function in pts with previous MI undergoing percutaneous coronary intervention (PCI). Aim: The aim of the study was to evaluate the relation between FFR and simultaneously evaluated coronary flow reserve by thermodilution (CFRthermo), with functional improvement of LV function in pts with previous MI undergoing PCI. Methods: Study population consisted of 50 pts (mean age 53±8 years; 40 male) with previous MI and significant coronary stenosis in one-vessel CAD (33 LAD, 4 Cx, 13 RCA) undergoing PCI of infarct-related coronary artery. In all pts we have evaluated by single pressure/thermo wire FFR and CFRthermo before and immediately after PCI. In all pts, we have evaluated LV ejection fraction by echo and wall motion score index (WMSI) before and 3 months after PCI. Results: Coronary lesions were successfully treated in all pts with decrease of diameter stenosis from 63±7% to 18±9% (p<0.001). FFR increased significantly (p<0.001) from 0.62±0.15 to 0.91±0.06 after PCI, whereas CFRthermo increased significantly (p<0.01) from 1.5±0.3 to 2.5±0.7. LV ejection fraction increased from 49±6% to 55±8% (p<0.0001), and WMSI decreased from 1.44±0.24 to 1.29±0.29 (p<0.0001). LV functional improvement was observed in 33/50 (66%) of pts. In pts with LV functional recovery in comparison to pts with no recovery there was significant difference in FFR before PCI (0.57±0.15 vs. 0.71±0.11, p=0.001), improvement of FFR during PCI (0.34±0.15 vs. 0.21±0.13, p=0.004), improvement of CFRthermo during PCI (1.2±0.6 vs. 0.6±0.5, p=0.001) and CFRthermo after PCI (2.7±0.7 vs. 2.1±0.6, p=0.008), respectively. Conclusion: Evaluation of FFR and CFRthermo provide significant prognostic information on LV functional recovery in pts with previous MI undergoing PCI. Lower FFR before PCI, higher CFRthermo after PCI, as well as higher improvement of FFR and CFRthermo during PCI are indicative of left ventricular functional improvement in pts with previous MI.

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