Transthoracic Doppler echocardiography assessment of left anterior descending artery flow in patients with previous anterior myocardial infarction.
OBJECTIVE
We tested the hypothesis that shortening of diastolic pressure half time (PHT) of left anterior descending (LAD) coronary flow in patients with old reperfused anterior myocardial infarction (MI) is related to the presence of permanent myocardial damage of the reperfused area.


RESULTS
We studied 49 patients divided into: group A: 15 patients with previous anterior MI and evidence of myocardial scar; group B: 10 patients with previous anterior MI and no evidence of myocardial scar and group C: 24 patients without anterior MI. All patients underwent coronary angiography at least 6 months after an index event and any reperfusion procedure. Group A patients had lower PHT (199 +/- 62 ms) than group C (377 +/- 103 ms, p = 0.0001) and group B (316 +/- 154 ms, p = 0.029) patients. No other LAD flow velocity parameter differed among the 3 groups. A PHT value of 265 ms discriminated patients with scarred anterior wall with a sensitivity of 79% and a specificity of 94% (0.88, p < 0.001).


CONCLUSIONS
Shortening of the LAD flow diastolic PHT in patients with remote, reperfused anterior MI reflects scarred myocardial tissue in the anteroapical wall while patients who maintain diastolic wall thickness after an acute coronary syndrome have PHT similar to patients without anterior MI.
Department of Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, 17674, Athens, Greece. georgekar2001@yahoo.com
George
G
Karatasakis
Evaggelos
E
Leontiadis
Emmanuil
E
Papadakis
Nikolaos
N
Koutsogiannis
George
G
Athanassopoulos
Konstantinos
K
Spargias
Don
D
Poldermans
Stefanos E
SE
Karagiannis
Dennis V
DV
Cokkinos
D000368:Aged; D001794:Blood Pressure; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*