Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size

• Published in: The International Journal of Cardiovascular Imaging 2014-12, Vol.30 (8), p.1509-1518
• Main Authors: Trifunovic, Danijela, Sobic-Saranovic, Dragana, Beleslin, Branko, Stankovic, Sanja, Marinkovic, Jelena, Orlic, Dejan, Vujisic-Tesic, Bosiljka, Petrovic, Milan, Nedeljkovic, Ivana, Banovic, Marko, Djukanovic, Nina, Petrovic, Olga, Petrovic, Marija, Stepanovic, Jelena, Djordjevic-Dikic, Ana, Tesic, Milorad, Ostojic, Miodrag
• Format: Article
• Language: English
• Subjects: Adenosine; Aged; Biomarkers - blood; Blood Flow Velocity; Cardiac Imaging; Cardiology; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Creatine Kinase, MB Form - blood; Echocardiography, Doppler; Feasibility Studies; Female; Fractional Flow Reserve, Myocardial; Humans; Imaging; Male; Medicine; Medicine & Public Health; Microcirculation; Middle Aged; Multivariate Analysis; Myocardial Infarction - blood; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocardial Perfusion Imaging - methods; Original Paper; Percutaneous Coronary Intervention; Predictive Value of Tests; Prospective Studies; Radiology; Serbia; Time Factors; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Vasodilator Agents
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-014-0497-6

Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = −0.686, p