Myocardial perfusion in ST-elevation myocardial infarction treated successfully with primary angioplasty.
OBJECTIVE
To study myocardial perfusion in ST-elevation myocardial infarction (STEMI) treated successfully with primary angioplasty. Additionally, to evaluate the predictive value of perfusion on subsequent infarct size.


METHODS
Fifty patients with acute STEMI and restoration of normal epicardial flow after primary angioplasty were included in the study. TIMI myocardial perfusion (TMP) grades were determined at the end of the procedure. Contrast enhanced magnetic resonance imaging (MRI) including first-pass perfusion and delayed enhancement imaging were performed within five days and after three months.


RESULTS
The patients were divided into two groups: A=TMP 0-1, B=TMP 2-3. The early MRI showed significantly reduced myocardial perfusion in the infarct zone compared to remote myocardium in both groups (p<0.001), but the reduction was more pronounced in group A. The infarct sizes were smaller (p=0.0017) and the ejection fractions higher (p=0.0001) in group B than in group A at follow-up.


CONCLUSIONS
In STEMI, early impairments in myocardial perfusion were observed in spite of successful treatment with angioplasty. Marked early impairments in perfusion were associated with larger infarct sizes on MRI after three months.
Hoffmann
Pavel
P
Department of Radiology, Ullevål University Hospital, Oslo, Norway.
Halvorsen
Sigrun
S
Stensaeth
Knut-Haakon
KH
Brekke
Magne
M
Müller
Carl
C
Anker
Gunvor Oyre
GO
Abdelnoor
Michael
M
Kløw
Nils Einar
NE
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods* / Q000592:standards*; D009664:Norway; D016896:Treatment Outcome
D003287:Contrast Media