title: Coronary artery flow velocity profile measured by transthoracic Doppler echocardiography predicts myocardial viability after acute myocardial infarction.
abstract: OBJECTIVE
  To study whether flow velocity profile in the left anterior descending coronary artery (LAD) measured by transthoracic Doppler echocardiography (TTDE) predicts myocardial viability after reperfused anterior acute myocardial infarction (AMI).
  
  
  METHODS
  15 patients who had their first anterior ST elevation AMI and were successfully reperfused by coronary angioplasty and five controls without coronary artery disease were selected. Blood flow velocity spectrum was measured from the mid-LAD by TTDE 3 days after coronary angioplasty. Myocardial viability in the LAD region was quantified 3 months after AMI by relative uptake of 18F-fluorodeoxyglucose (FDG) imaged with positron emission tomography. Myocardium was graded as viable, partially viable or non-viable (relative FDG uptake >85%, 67-85% and <67%, respectively). Main outcome measures were diastolic deceleration time (DDT) of LAD flow velocity 3 days after AMI and myocardial viability 3 months after AMI.
  
  
  RESULTS
  DDT of LAD flow velocity correlated with myocardial FDG uptake in the LAD region (r = 0.91, p<0.01). DDT was markedly longer in patients with viable myocardium (876+/-76 ms, n = 3) than partially viable (356+/-89 ms, n = 6, p<0.01), or non-viable myocardium (128+/-13 ms, n = 6, p<0.01). In controls, DDT was comparable (909+/-76 ms, n = 5) to patients with viable myocardium. DDT <190 ms was always associated with non-viable myocardium.
  
  
  CONCLUSIONS
  DDT of LAD flow velocity is strongly associated with myocardial viability after reperfused anterior AMI. Non-invasive TTDE of the LAD may be used in the acute phase to predict long-term viability of the jeopardised myocardium.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 6-8, 20520 Turku, Finland. antti.saraste@utu.fi
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Juha W
authors.initials: JW
authors.lastname: Koskenvuo
authors.forename: Markku
authors.initials: M
authors.lastname: Saraste
authors.forename: Jussi
authors.initials: J
authors.lastname: Pärkkä
authors.forename: Jyri
authors.initials: J
authors.lastname: Toikka
authors.forename: Alexandru
authors.initials: A
authors.lastname: Naum
authors.forename: Heikki
authors.initials: H
authors.lastname: Ukkonen
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.forename: Juhani
authors.initials: J
authors.lastname: Airaksinen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Hartiala
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology*; D004452:Echocardiography / Q000592:standards; D015150:Echocardiography, Doppler / Q000592:standards; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D015425:Myocardial Reperfusion; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18