title: Clinical significance of no-reflow phenomenon observed on angiography after successful treatment of acute myocardial infarction with percutaneous transluminal coronary angioplasty.
abstract: The clinical significance of the angiographic no-reflow phenomenon was evaluated in 93 patients with acute myocardial infarction treated by percutaneous transluminal coronary angioplasty (PTCA). On the basis of the post-PTCA angiograms, patients were divided into three groups: normal angiogram (group 1, n = 65), slight no-reflow (group 2, n = 13), and severe no-reflow (group 3, n = 15). Regional wall motion in the chronic phase was depressed in groups 2 and 3 compared with group 1. The proportion of the area of the transmural infarction to that of the total infarction determined by scintigraphy was higher in groups 2 and 3 than in group 1. A significantly higher incidence of myocardial rupture and of death resulting from cardiac causes was observed in group 3 compared with group 1. The severity of this phenomenon immediately after an emergency PTCA correlated well with the severity of myocardial damage, with patients having severe no-reflow showing the poorest prognosis.
authors.affiliation: Department of Cardiology, Ogaki Municipal Hospital, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Morishima
authors.forename: T
authors.initials: T
authors.lastname: Sone
authors.forename: S
authors.initials: S
authors.lastname: Mokuno
authors.forename: S
authors.initials: S
authors.lastname: Taga
authors.forename: A
authors.initials: A
authors.lastname: Shimauchi
authors.forename: Y
authors.initials: Y
authors.lastname: Oki
authors.forename: J
authors.initials: J
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Tsuboi
authors.forename: H
authors.initials: H
authors.lastname: Sassa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003326:Coronary Circulation; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006342:Heart Rupture, Post-Infarction / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes; D003402:Creatine Kinase