title: Analysis of serial coronary artery flow patterns early after primary angioplasty: new insights into the dynamics of the microcirculation.
abstract: BACKGROUND
  The temporal behavior of the coronary microcirculation in acute myocardial infarction may affect outcome. Diastolic deceleration time and early systolic flow reversal derived from coronary artery blood flow velocity patterns reflect microcirculatory function.
  
  
  OBJECTIVE
  To assess left anterior descending coronary artery flow velocity patterns using Doppler transthoracic echocardiography after primary percutaneous coronary intervention, in patients with anterior AMI.
  
  
  METHODS
  Patterns of flow velocity patterns of the LAD were obtained using transthoracic echocardiography-Doppler in 31 consecutive patients who presented with anterior AMI. Measurements were done at 6 hours, 36-48 hours, and 5 days after successful PPCI. Measurements of DDT and pressure half times (Pt%), as well as observation for ESFR were performed.
  
  
  RESULTS
  In the first 2 days following PPCI, the average DDT (600 +/- 340 msec) was shorter than on day 5 (807 +/- 332 msec) (P < 0.012), FVP in the first 2 days were dynamic and bidirectional: from short DDT (< 600 msec) to long DDT (> 600 msec) and vice versa. On day 5 most DDTs became longer. Pt1/2 at 6 hours was not different than at day 2 (174 +/- 96 vs. 193 +/- 99 msec, P = NS) and became longer on day 5 (235 +/- 98 msec, P = 0.012). Bidirectional patterns were also observed in the ESFR in 6 patients (19%) at baseline, in 4 (13%) at 36 hours, and in 2 (6.5%) on day 5 after PPCI.
  
  
  CONCLUSIONS
  Flow velocity patterns of the LAD after PPCI in AMI are dynamic and reflect unpredictable changes in microcirculation.
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. dawod.sharif@b-zion.org.il
authors.forename: Dawod
authors.initials: D
authors.lastname: Sharif
authors.forename: Guy
authors.initials: G
authors.lastname: Rofe
authors.forename: Amal
authors.initials: A
authors.lastname: Sharif-Rasslan
authors.forename: Ehud
authors.initials: E
authors.lastname: Goldhammer
authors.forename: Nabeel
authors.initials: N
authors.lastname: Makhoul
authors.forename: Arie
authors.initials: A
authors.lastname: Shefer
authors.forename: Amin
authors.initials: A
authors.lastname: Hassan
authors.forename: Shmuel
authors.initials: S
authors.lastname: Rauchfleisch
authors.forename: Uri
authors.initials: U
authors.lastname: Rosenschein
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors