Quantitative estimation of myocardial salvage after primary percutaneous transluminal coronary angioplasty in patients with angiographic no reflow View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2002-12-19

AUTHORS

Seishi Nakamura, Kazuya Takehana, Tetsuro Sugiura, Kengo Hatada, Shinichi Hamada, Junko Asada, Reisuke Yuyama, Jun Mimura, Yusuke Imuro, Hirohiko Kurihara, Masayoshi Fukui, Masato Baden, Toshiji Iwasaka

ABSTRACT

Angiographic Thrombolysis in Myocardial Infarction (TIMI) flow grade <2 after primary percutaneous transluminal coronary angioplasty (PTCA), defined as angiographic no reflow, predicts poor left ventricular functional recovery and survival in patients with acute myocardial infarction (MI). To determine the relation between angiographic coronary flow and myocardial salvage in the acute phase of MI, serial technetium-99m tetrofosmin imaging was performed before, immediately after and 1 month after PTCA in 117 patients. Angiographic no reflow was observed in 23 patients (20%; group 1), while 94 patients did not have angiographic no reflow (group 2). Although there was no significant difference in the defect score before PTCA between the two groups (group 1, 14.4±5.7; group 2, 13.5±4.6), the defect score immediately after PTCA in group 1 was significantly higher than that in group 2 (group 1, 12.8±5.1; group 2, 8.9±4.6; P <0.0001). A significantly smaller change in the defect score after PTCA (before minus immediately after PTCA) was observed in group 1 as compared with group 2 (group 1, 1.7±2.0; group 2, 4.5±2.9; P <0.0001). Twenty patients in group 1 (87%) had impaired myocardial reperfusion (<4 change in the defect score immediately after PTCA), as compared with 36 patients (38%) in group 2; this difference was significant (χ2=17.5, P <0.0001). The sensitivity, specificity and accuracy of angiographic no reflow in estimating impaired myocardial reperfusion were 36%, 95% and 67%, respectively. Thus, angiographic no reflow is a highly specific, although not sensitive, marker of impaired myocardial reperfusion immediately after primary PTCA. More... »

PAGES

383-389

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00259-002-1063-3

DOI

http://dx.doi.org/10.1007/s00259-002-1063-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024651197

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/12634966


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24 schema:description Angiographic Thrombolysis in Myocardial Infarction (TIMI) flow grade <2 after primary percutaneous transluminal coronary angioplasty (PTCA), defined as angiographic no reflow, predicts poor left ventricular functional recovery and survival in patients with acute myocardial infarction (MI). To determine the relation between angiographic coronary flow and myocardial salvage in the acute phase of MI, serial technetium-99m tetrofosmin imaging was performed before, immediately after and 1 month after PTCA in 117 patients. Angiographic no reflow was observed in 23 patients (20%; group 1), while 94 patients did not have angiographic no reflow (group 2). Although there was no significant difference in the defect score before PTCA between the two groups (group 1, 14.4±5.7; group 2, 13.5±4.6), the defect score immediately after PTCA in group 1 was significantly higher than that in group 2 (group 1, 12.8±5.1; group 2, 8.9±4.6; P <0.0001). A significantly smaller change in the defect score after PTCA (before minus immediately after PTCA) was observed in group 1 as compared with group 2 (group 1, 1.7±2.0; group 2, 4.5±2.9; P <0.0001). Twenty patients in group 1 (87%) had impaired myocardial reperfusion (<4 change in the defect score immediately after PTCA), as compared with 36 patients (38%) in group 2; this difference was significant (χ2=17.5, P <0.0001). The sensitivity, specificity and accuracy of angiographic no reflow in estimating impaired myocardial reperfusion were 36%, 95% and 67%, respectively. Thus, angiographic no reflow is a highly specific, although not sensitive, marker of impaired myocardial reperfusion immediately after primary PTCA.
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32 accuracy
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36 angiographic coronary flow
37 angioplasty
38 changes
39 coronary angioplasty
40 coronary flow
41 defect score
42 differences
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44 flow
45 functional recovery
46 grade
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50 imaging
51 infarction
52 markers
53 months
54 myocardial infarction
55 myocardial reperfusion
56 myocardial salvage
57 patients
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62 quantitative estimation
63 recovery
64 reflow
65 relation
66 reperfusion
67 salvage
68 scores
69 sensitivity
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72 small changes
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74 survival
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