title: [Usefulness of diastolic deceleration time assessed by transthoracic Doppler measurement in the detection of sustained microvascular obstruction in STEMI patients treated by primary PTCA].
abstract: OBJECTIVE
  To assess the value of coronary flow measurement by transthoracic Doppler technique in the detection of "no-reflow" phenomenon.
  
  
  METHODS
  Fourteen patients with first anterior wall infarction treated by successful (TIMI3) primary percutaneous angioplasty and left descending coronary artery stenting were investigated. Myocardial perfusion following PCI was assessed by (i) ST-segment resolution, (ii) MRI-detected microvascular obstruction (early hypoenhancement), (iii) coronary flow pattern measurement by transthoracic Doppler technique.
  
  
  RESULTS
  Sustained impairment of myocardial perfusion following PCI was observed in a large proportion of the cohort (36% by MRI, 43% by ST regression analysis). Patients with a diastolic deceleration time inferior to 482 ms had higher troponin and CK peak value, higher wall motion index score, lower ST resolution and lower LVEF assessed by MRI. The concordance of the three methods was 80%.
  
  
  CONCLUSIONS
  The measurement of diastolic deceleration time by transthoracic Doppler technique is a reliable technique to identify microvascular obstruction following PCI in acute anterior STEMI. A DDT inferior to 482 ms is associated with sustained "no-reflow" phenomenon.
authors.affiliation: Pôle d'activité médicochirurgicale des Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, université de Strasbourg, France.
authors.forename: M
authors.initials: M
authors.lastname: Messas
authors.forename: A
authors.initials: A
authors.lastname: Trinh
authors.forename: L
authors.initials: L
authors.lastname: Jesel
authors.forename: B
authors.initials: B
authors.lastname: Radulescu
authors.forename: P
authors.initials: P
authors.lastname: Germain
authors.forename: P
authors.initials: P
authors.lastname: Ohlmann
authors.forename: P
authors.initials: P
authors.lastname: Bareiss
authors.forename: O
authors.initials: O
authors.lastname: Morel
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D001783:Blood Flow Velocity / Q000502:physiology; D003971:Diastole / Q000502:physiology*; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology