Assessment of myocardial viability using coronary zero flow pressure after successful angioplasty in patients with acute anterior myocardial infarction.
OBJECTIVE
To investigate the relation between coronary flow reserve (CFR), coronary zero flow pressure (Pzf), and residual myocardial viability in patients with acute myocardial infarction.


METHODS
Prospective study.


METHODS
Primary care hospital.


METHODS
27 consecutive patients with acute anterior myocardial infarction.


METHODS
F-fluorodeoxyglucose (FDG) positron emission tomography (PET) was used in 27 patients who underwent successful intervention within 12 hours of onset of a first acute anterior myocardial infarction. Within three days before discharge they had < 25% stenosis in the culprit lesion as determined by angiography 24 (3) days after acute myocardial infarction. Pzf and the slope index of the flow-pressure relation (SIFP) were calculated from the simultaneously recorded aortic pressure and coronary flow velocity signals at peak hyperaemia.%FDG was quantified by comparing FDG uptake in the infarct myocardium with FDG uptake in the normal myocardium.


RESULTS
There was a correlation between %FDG and CFR, where y = -1.477x + 62.517, r = -0.072 (NS). There was also a correlation between %FDG and SIFP, where y = -0.975x + 60.542, r = -0.045 (NS), and a significant correlation between %FDG and Pzf, where y = -0.98x + 85.108, r = -0.696 (p < 0.001).


CONCLUSIONS
CFR does not correlate with FDG-PET at the time of postreperfusion evaluation of residual myocardial viability. The parameter that correlates best with residual myocardial viability is Pzf and this may be a useful index for predicting patient prognosis.
Shimada
K
K
Department of Internal Medicine and Cardiology Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan. shimadak@msic.med.osaka-cu.ac.jp
Sakanoue
Y
Y
Kobayashi
Y
Y
Ehara
S
S
Hirose
M
M
Nakamura
Y
Y
Fukuda
D
D
Yamagishi
H
H
Yoshiyama
M
M
Takeuchi
K
K
Yoshikawa
J
J
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods; D001783:Blood Flow Velocity / Q000502:physiology; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D004452:Echocardiography / Q000379:methods; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D009206:Myocardium; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015912:Thrombolytic Therapy / Q000379:methods; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014665:Vasodilator Agents / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D019788:Fluorodeoxyglucose F18