title: Relationship between systolic pulsed wave tissue Doppler parameters and both invasive and noninvasive reperfusion criteria in patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  Despite normal flow in the infarct-related artery after primary percutaneous coronary intervention, patients may not achieve adequate perfusion at the tissue level. We examined the applicability of pulsed wave tissue Doppler (PTD) in detection of successful myocardial reperfusion.
  
  
  METHODS
  In all, 24 patients with anterior infarction were enrolled. All patients underwent primary percutaneous coronary intervention. PTD was performed 2 days and 2 weeks after percutaneous coronary intervention, and recorded from 6 different locations at the mitral annular level. Peak systolic wave was determined and was related to various markers of reperfusion.
  
  
  RESULTS
  Systolic PTD measurement in patients with myocardial blush grades 0 to 1 significantly deteriorated between second day and second week (6.5 +/- 1.1-5.3 +/- 1.1 for the anterior wall, and 6.2 +/- 1.3-5.3 +/- 1 for the anterior septum, P < .05 and P < .01, respectively). Systolic PTD parameters improved significantly in patients with myocardial blush grades 2 to 3 (6 +/- 1.5-7.2 +/- 2 for the anterior wall, and 5.4 +/- 1.1-7.1 +/- 1.6 for the anterior septum, P < .05 and P < .01, respectively). A significant relationship was observed between PTD and thrombolysis in myocardial infarction flow, S-T resolution, and creatine phosphokinase peaking. PTD recovery was highly sensitive and specific for the detection of left ventricular function recovery.
  
  
  CONCLUSIONS
  We demonstrated a significant relationship between systolic PTD parameters and invasive and noninvasive markers of reperfusion. Larger studies are needed to confirm these results.
authors.affiliation: Cardiology Department, Ain Shams University Hospital, Cairo, Egypt. msabdelwahab@gmail.com
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Wahab
authors.forename: Ghada
authors.initials: G
authors.lastname: El-Shahed
authors.forename: Hany
authors.initials: H
authors.lastname: Awadalla
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amin
authors.forename: Walid
authors.initials: W
authors.lastname: El-Hammady
authors.forename: Amal
authors.initials: A
authors.lastname: Ayoub
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D017023:Coronary Angiography; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D015425:Myocardial Reperfusion; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin