急性心肌梗死直接血管成形术后无创性冠状动脉血流储备与微血管完整性和心肌生存能力相关  

Non-invasive coronary flow reserve is correlated with microvascular integrity and myocardial viability after primary angioplasty in acute myocardial infarction

作　　者：Montisci R. Ruscazio M. 王海玲 

机构地区：[1]Department of Cardiovascular and Neurological Sciences, University of Cagliari, Ospedale S Giovanni di Dio, via Ospedale 46, 09124, Cagliari, Italy Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第12期47-47,共1页

摘　　要：Objective: To test whether preserved coronary flow reserve(CFR) two days after reperfused acute myocardial infarction(AMI) is associated with less microvascular dysfunction(“noreflow”phenomenon) and is predictive of myocardial viability. Design: 24 patients with anterior AMI underwent CFR assessment in the left anterior descending coronary artery(LAD) with transthoracic echocardiography and myocardial contrast echocardiography(MCE) 48 h after primary angioplasty in the LAD(mean 4(SD 2) and 3(1) days, respectively). Low-dose dobutamine echocardiography was performed 6(3) days after AMI and follow-up echocardiography at three months. Results: Noreflow extent was greater in patients with impaired CFR(< 2.5) than in those with preserved CFR( >2.5)(55(35)%v 11(25)%, p< 0.001). MCE reflow was more common in patients with preserved CFR(8/12) than in those with reduced CFR(1/12, p< 0.05). Wall motion score index in the LAD territory(A-WMSI) was similar at the first echocardiography(2.14(0.39) v 2.32(0.47),NS), although it was better in patients with preserved CFR at dobutamine(1.38(0.45) v 1.97(0.67), p< 0.05) and follow-up echocardiography(1.36(0.40) v 1.97(0.64), p< 0.05). An inverse correlation was found between CFR and A-WMSI at dobutamine and follow-up echocardiography(r=-0.49, p=0.016 and r=-0.55, p=0.005) and between MCE and A-WMSI at dobutamine and follow-up echocardiography(r=-0.75, p< 0.001 and r=-0.75, p< 0.001). By multivariate analysis MCE reflow remained the only predictor of recovery at both dobutamine and follow-up echocardiography(odds ratio 1.06, 95%Cl 1 to 1.1, p=0.009). Conclusion: CFR is inversely correlated with the extent of microvascular dysfunction at MCE two days after reperfused AMI. CFR and MCE reflow early after AMI are correlated with myocardial viability at follow up.Objective: To test whether preserved coronary flow reserve(CFR) two days after reperfused acute myocardial infarction(AMI) is associated with less microvascular dysfunction(“noreflow”phenomenon) and is predictive of myocardial viability. Design: 24 patients with anterior AMI underwent CFR assessment in the left anterior descending coronary artery(LAD) with transthoracic echocardiography and myocardial contrast echocardiography(MCE) 48 h after primary angioplasty in the LAD(mean 4(SD 2) and 3(1) days, respec...

关 键 词：冠状动脉血流储备 直接血管成形术 心肌梗死 生存能力 多巴酚丁胺负荷超声心动图 微血管 

分 类 号：R542.22[医药卫生—心血管疾病]