Abstract
The no reflow phenomenon and left ventricular (LV) diastolic dysfunction are surrogate markers of poor outcomes in patients with myocardial infarction (MI). We studied the relationship between contrast perfusion defects and restrictive filling patterns for predicting prognosis after MI. Mitral inflow velocity and myocardial contrast perfusion were studied 2 weeks after reperfusion in 226 consecutive patients with acute MI. The cohort was divided into two groups according to the number of perfusion defect segments (PD); large-PD and small-PD. Mitral inflow was classified into two categories according to deceleration time; non-restrictive and restrictive. The patients were divided into 4 groups (small-PD/non-restrictive, n = 124; small-PD/restrictive, n = 29; large-PD/non-restrictive, n = 50; large-PD/restrictive, n = 23). LV end-diastolic volume index was the greatest and cardiac event rate was the highest in large-PD/restrictive, followed by large-PD/ non-restrictive, small-PD/restrictive, and by small- PD/non-restrictive (81 ± 19 vs. 74 ± 17 vs. 66 ± 19 vs. 59 ± 15ml/m2, events: 61 % vs. 16% vs. 14% vs. 8 %). Multivariate analysis revealed the large-PD is the most powerful predictive factor related to cardiac events (odds ratio = 5.5, P = 0.004) followed by the restrictive filing pattern (4.3, P = 0.005). Co-existence of large-PD and restrictive filling is a strong predictor of adverse outcomes in the patients with MI.
| Original language | English |
|---|---|
| Pages (from-to) | 400-407 |
| Number of pages | 8 |
| Journal | Basic Research in Cardiology |
| Volume | 101 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sep 2006 |
| Externally published | Yes |
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Keywords
- Ccontrast medium
- Echocardiography
- Microcirculation
- Myocardial infarction
- Relaxation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Combination study of myocardial perfusion and left ventricular filling provides an excellent prediction of clinical outcomes in patients with reperfused myocardial infarction. / Itoh, Hiroshi; Komura, N.; Iwakura, K.; Kawano, S.; Okamura, A.; Fujii, K.
In: Basic Research in Cardiology, Vol. 101, No. 5, 09.2006, p. 400-407.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combination study of myocardial perfusion and left ventricular filling provides an excellent prediction of clinical outcomes in patients with reperfused myocardial infarction
AU - Itoh, Hiroshi
AU - Komura, N.
AU - Iwakura, K.
AU - Kawano, S.
AU - Okamura, A.
AU - Fujii, K.
PY - 2006/9
Y1 - 2006/9
N2 - The no reflow phenomenon and left ventricular (LV) diastolic dysfunction are surrogate markers of poor outcomes in patients with myocardial infarction (MI). We studied the relationship between contrast perfusion defects and restrictive filling patterns for predicting prognosis after MI. Mitral inflow velocity and myocardial contrast perfusion were studied 2 weeks after reperfusion in 226 consecutive patients with acute MI. The cohort was divided into two groups according to the number of perfusion defect segments (PD); large-PD and small-PD. Mitral inflow was classified into two categories according to deceleration time; non-restrictive and restrictive. The patients were divided into 4 groups (small-PD/non-restrictive, n = 124; small-PD/restrictive, n = 29; large-PD/non-restrictive, n = 50; large-PD/restrictive, n = 23). LV end-diastolic volume index was the greatest and cardiac event rate was the highest in large-PD/restrictive, followed by large-PD/ non-restrictive, small-PD/restrictive, and by small- PD/non-restrictive (81 ± 19 vs. 74 ± 17 vs. 66 ± 19 vs. 59 ± 15ml/m2, events: 61 % vs. 16% vs. 14% vs. 8 %). Multivariate analysis revealed the large-PD is the most powerful predictive factor related to cardiac events (odds ratio = 5.5, P = 0.004) followed by the restrictive filing pattern (4.3, P = 0.005). Co-existence of large-PD and restrictive filling is a strong predictor of adverse outcomes in the patients with MI.
AB - The no reflow phenomenon and left ventricular (LV) diastolic dysfunction are surrogate markers of poor outcomes in patients with myocardial infarction (MI). We studied the relationship between contrast perfusion defects and restrictive filling patterns for predicting prognosis after MI. Mitral inflow velocity and myocardial contrast perfusion were studied 2 weeks after reperfusion in 226 consecutive patients with acute MI. The cohort was divided into two groups according to the number of perfusion defect segments (PD); large-PD and small-PD. Mitral inflow was classified into two categories according to deceleration time; non-restrictive and restrictive. The patients were divided into 4 groups (small-PD/non-restrictive, n = 124; small-PD/restrictive, n = 29; large-PD/non-restrictive, n = 50; large-PD/restrictive, n = 23). LV end-diastolic volume index was the greatest and cardiac event rate was the highest in large-PD/restrictive, followed by large-PD/ non-restrictive, small-PD/restrictive, and by small- PD/non-restrictive (81 ± 19 vs. 74 ± 17 vs. 66 ± 19 vs. 59 ± 15ml/m2, events: 61 % vs. 16% vs. 14% vs. 8 %). Multivariate analysis revealed the large-PD is the most powerful predictive factor related to cardiac events (odds ratio = 5.5, P = 0.004) followed by the restrictive filing pattern (4.3, P = 0.005). Co-existence of large-PD and restrictive filling is a strong predictor of adverse outcomes in the patients with MI.
KW - Ccontrast medium
KW - Echocardiography
KW - Microcirculation
KW - Myocardial infarction
KW - Relaxation
UR - http://www.scopus.com/inward/record.url?scp=33747753147&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747753147&partnerID=8YFLogxK
U2 - 10.1007/s00395-006-0619-y
DO - 10.1007/s00395-006-0619-y
M3 - Article
C2 - 16915527
AN - SCOPUS:33747753147
VL - 101
SP - 400
EP - 407
JO - Basic Research in Cardiology
JF - Basic Research in Cardiology
SN - 0300-8428
IS - 5
ER -