Temporal changes in myocardial perfusion patterns in patients with reperfused anterior wall myocardial infarction: Their relation to myocardial viability

Hiroshi Itoh, K. Iwakura, Hidemasa Oh, T. Masuyama, M. Hori, Y. Higashino, K. Fujii, T. Minamino

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Background: Several studies demonstrated ischemic microvascular damage in patients with acute myocardial infarction (AMI). In this study, myocardial contrast echocardiography (MCE) was used to assess the temporal changes in myocardial perfusion after reflow and to investigate the relation between MCE findings and myocardial viability. Methods and Results: MCE was performed with the intracoronary injection of sonicated microbubbles before and shortly after coronary reflow and 1 month later in 45 patients with anterior wall AMI. MCE before reflow was analyzed to determine the risk area as an area of contrast defect in the apical long axis view. MCE images after reperfusion were analyzed to determine peak contrast intensity, which should be in proportion to the concentration of microbubbles within the microvasculature and in the infarcted and normal myocardium, and the ratio of these (PI ratio) was used to assess microvascular integrity. Areas of residual contrast defect were expressed as a ratio to those of left ventricular myocardium (RCD ratio) to assess the spatial extent of the MCE 'no reflow'. Regional wall motion (RWM, SD per chord) in the territory of the left anterior descending coronary artery was determined by the centerline method in both the acute and late stages. Although the PI ratio was extremely low shortly after coronary reflow, it increased in the late stage of AMI with the improvement in regional contractile function (RWM, -3.2±0.5 versus -2.6±1.0, P

Original languageEnglish
Pages (from-to)656-662
Number of pages7
JournalCirculation
Volume91
Issue number3
Publication statusPublished - 1995
Externally publishedYes

Fingerprint

Anterior Wall Myocardial Infarction
Echocardiography
Perfusion
Microbubbles
Myocardium
Myocardial Infarction
Microvessels
Reperfusion
Coronary Vessels
Injections

Keywords

  • contrast media
  • echocardiography
  • microcirculation
  • myocardial infarction
  • reperfusion

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Temporal changes in myocardial perfusion patterns in patients with reperfused anterior wall myocardial infarction : Their relation to myocardial viability. / Itoh, Hiroshi; Iwakura, K.; Oh, Hidemasa; Masuyama, T.; Hori, M.; Higashino, Y.; Fujii, K.; Minamino, T.

In: Circulation, Vol. 91, No. 3, 1995, p. 656-662.

Research output: Contribution to journalArticle

Itoh, Hiroshi ; Iwakura, K. ; Oh, Hidemasa ; Masuyama, T. ; Hori, M. ; Higashino, Y. ; Fujii, K. ; Minamino, T. / Temporal changes in myocardial perfusion patterns in patients with reperfused anterior wall myocardial infarction : Their relation to myocardial viability. In: Circulation. 1995 ; Vol. 91, No. 3. pp. 656-662.
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AU - Itoh, Hiroshi

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AU - Hori, M.

AU - Higashino, Y.

AU - Fujii, K.

AU - Minamino, T.

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