Abstract
OBJECTIVES: We sought to determine which of the two main potential mechanisms underlying Thrombolysis In Myocardial Infarction flow grade 2 (TIMI-2 flow) operate in an individual patient who has had an acute myocardial infarction (AMI). BACKGROUND: Systolic flow reversal (SFR) is a specific finding of capillary damage, the no-reflow phenomenon. The coronary blood flow velocity (CBFV) pattern of thromboemboli, however, remains unknown. METHODS: Data on 105 patients with AMI (57 with anterior and 48 with nonanterior cases) who underwent a coronary, intervention were analyzed. The CBFV was recorded by a Doppler guide wire, and tissue perfusion was assessed with myocardial contrast echocardiography (MCE). RESULTS: Study patients were classified into three groups according to TIMI grade and the presence or absence of SFR: 1) TIMI-3 flow (n = 80); 2) TIMI-2 flow with SFR (SFR[+], n = 14); and 3) TIMI-2 flow without SFR (SFR[-], n = 11). Diastolic CBFV was the lowest in SFR(-) (TIMI-3 vs. SFR[+] vs. SFR[-]: 34 vs. 31 vs. 9 cm/s), and the systolic to diastolic CBFV ratio was also the highest in SFR(-) (0.43 vs. -0.18 vs. 0.66). The no-reflow phenomenon documented by MCE was found in all patients in the SFR(+) group, but in only one patient (10%) in the SFR(-) group. Intracoronary thrombus was more frequently found in SFR(-) than in SFR(+) (91% vs. 14%, p <0.05). CONCLUSIONS: At least two different CBFV patterns are noted in patients with reperfused AMI who have TIMI-2 flow. Capillary damage is mostly responsible for SFR(+), and SFR(-) is seen in thromboemboli possibly due to increased coronary arterial resistance.
| Original language | English |
|---|---|
| Pages (from-to) | 1755-1760 |
| Number of pages | 6 |
| Journal | Journal of the American College of Cardiology |
| Volume | 40 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Nov 20 2002 |
| Externally published | Yes |
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Two different coronary blood flow velocity patterns in thrombolysis in myocardial infarction flow grade 2 in acute myocardial infarction : Insight into mechanisms of microvascular dysfunction. / Yamamoto, Koichi; Itoh, Hiroshi; Iwakura, Katsuomi; Kawano, Shigeo; Ikushima, Masashi; Masuyama, Tohru; Ogihara, Toshio; Fujii, Kenshi.
In: Journal of the American College of Cardiology, Vol. 40, No. 10, 20.11.2002, p. 1755-1760.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Two different coronary blood flow velocity patterns in thrombolysis in myocardial infarction flow grade 2 in acute myocardial infarction
T2 - Insight into mechanisms of microvascular dysfunction
AU - Yamamoto, Koichi
AU - Itoh, Hiroshi
AU - Iwakura, Katsuomi
AU - Kawano, Shigeo
AU - Ikushima, Masashi
AU - Masuyama, Tohru
AU - Ogihara, Toshio
AU - Fujii, Kenshi
PY - 2002/11/20
Y1 - 2002/11/20
N2 - OBJECTIVES: We sought to determine which of the two main potential mechanisms underlying Thrombolysis In Myocardial Infarction flow grade 2 (TIMI-2 flow) operate in an individual patient who has had an acute myocardial infarction (AMI). BACKGROUND: Systolic flow reversal (SFR) is a specific finding of capillary damage, the no-reflow phenomenon. The coronary blood flow velocity (CBFV) pattern of thromboemboli, however, remains unknown. METHODS: Data on 105 patients with AMI (57 with anterior and 48 with nonanterior cases) who underwent a coronary, intervention were analyzed. The CBFV was recorded by a Doppler guide wire, and tissue perfusion was assessed with myocardial contrast echocardiography (MCE). RESULTS: Study patients were classified into three groups according to TIMI grade and the presence or absence of SFR: 1) TIMI-3 flow (n = 80); 2) TIMI-2 flow with SFR (SFR[+], n = 14); and 3) TIMI-2 flow without SFR (SFR[-], n = 11). Diastolic CBFV was the lowest in SFR(-) (TIMI-3 vs. SFR[+] vs. SFR[-]: 34 vs. 31 vs. 9 cm/s), and the systolic to diastolic CBFV ratio was also the highest in SFR(-) (0.43 vs. -0.18 vs. 0.66). The no-reflow phenomenon documented by MCE was found in all patients in the SFR(+) group, but in only one patient (10%) in the SFR(-) group. Intracoronary thrombus was more frequently found in SFR(-) than in SFR(+) (91% vs. 14%, p <0.05). CONCLUSIONS: At least two different CBFV patterns are noted in patients with reperfused AMI who have TIMI-2 flow. Capillary damage is mostly responsible for SFR(+), and SFR(-) is seen in thromboemboli possibly due to increased coronary arterial resistance.
AB - OBJECTIVES: We sought to determine which of the two main potential mechanisms underlying Thrombolysis In Myocardial Infarction flow grade 2 (TIMI-2 flow) operate in an individual patient who has had an acute myocardial infarction (AMI). BACKGROUND: Systolic flow reversal (SFR) is a specific finding of capillary damage, the no-reflow phenomenon. The coronary blood flow velocity (CBFV) pattern of thromboemboli, however, remains unknown. METHODS: Data on 105 patients with AMI (57 with anterior and 48 with nonanterior cases) who underwent a coronary, intervention were analyzed. The CBFV was recorded by a Doppler guide wire, and tissue perfusion was assessed with myocardial contrast echocardiography (MCE). RESULTS: Study patients were classified into three groups according to TIMI grade and the presence or absence of SFR: 1) TIMI-3 flow (n = 80); 2) TIMI-2 flow with SFR (SFR[+], n = 14); and 3) TIMI-2 flow without SFR (SFR[-], n = 11). Diastolic CBFV was the lowest in SFR(-) (TIMI-3 vs. SFR[+] vs. SFR[-]: 34 vs. 31 vs. 9 cm/s), and the systolic to diastolic CBFV ratio was also the highest in SFR(-) (0.43 vs. -0.18 vs. 0.66). The no-reflow phenomenon documented by MCE was found in all patients in the SFR(+) group, but in only one patient (10%) in the SFR(-) group. Intracoronary thrombus was more frequently found in SFR(-) than in SFR(+) (91% vs. 14%, p <0.05). CONCLUSIONS: At least two different CBFV patterns are noted in patients with reperfused AMI who have TIMI-2 flow. Capillary damage is mostly responsible for SFR(+), and SFR(-) is seen in thromboemboli possibly due to increased coronary arterial resistance.
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U2 - 10.1016/S0735-1097(02)02486-5
DO - 10.1016/S0735-1097(02)02486-5
M3 - Article
C2 - 12446058
AN - SCOPUS:0037145923
VL - 40
SP - 1755
EP - 1760
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 10
ER -