title: Coronary flow velocity pattern immediately after percutaneous coronary intervention as a predictor of complications and in-hospital survival after acute myocardial infarction.
abstract: BACKGROUND
  Recently, it was reported that the degree of microvascular injury and left ventricular functional recovery during the chronic period can be predicted after treatment of the infarct-related artery based on the coronary flow velocity (CFV) pattern assessed using a Doppler guidewire. The aim of this prospective study was to examine whether the CFV pattern may predict complications and in-hospital survival after acute myocardial infarction (AMI).
  
  
  RESULTS
  The study population consisted of 169 consecutive patients with a first anterior AMI successfully treated with percutaneous coronary intervention (PCI). We examined the CFV pattern immediately after PCI using a Doppler guidewire. In accordance with previous findings, we defined severe microvascular injury as a diastolic deceleration time < or =600 ms and the presence of systolic flow reversal. Patients were divided into two groups: those without severe microvascular injury (n=118; group 1) and those with severe microvascular injury (n=51; group 2). All of the patients who had cardiac rupture were in group 2. Congestive heart failure (CHF) was observed more frequently in group 2 than in group 1 (53% versus 8%, P<0.001). The in-hospital cardiac mortality rate was significantly higher in group 2 than in group 1 (18% versus 0%, P<0.001). Nine patients in group 2 died, 5 patients because of CHF and 4 patients because of cardiac rupture.
  
  
  CONCLUSIONS
  These findings suggest that the CFV pattern is an accurate predictor of the presence or absence of complications and of in-hospital survival after AMI.
authors.affiliation: Division of Cardiology, Kobe General Hospital, Kobe, Japan. minakozk@gold.ocn.ne.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamamuro
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Tamita
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamabe
authors.forename: Minako
authors.initials: M
authors.lastname: Katayama
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takagi
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Morioka
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D003971:Diastole; D004301:Doppler Effect; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006341:Heart Rupture / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013599:Systole; D014463:Ultrasonography