Coronary artery diseaseTime Course of Microvascular Resistance of the Infarct and Noninfarct Coronary Artery Following an Anterior Wall Acute Myocardial Infarction
Section snippets
Patient selection
We studied 100 consecutive patients who presented with a first anterior wall AMI that was treated with primary angioplasty. AMI was defined as chest pain that lasted >30 minutes in conjunction with persistent ST-segment elevation ≥2 mV in 2 adjacent precordial leads. Exclusion criteria were cardiogenic shock (systolic blood pressure <90 mm Hg despite conservative measurements), previous AMI, previous coronary artery bypass surgery, previous left ventricular ejection fraction <40%, acute
Results
Patients’ baseline characteristics are listed in Table 2.
A time-dependent improvement of CFVR in IRAs and non-IRAs remained significant after correction for the rate–pressure product (Table 1). Uncorrected and corrected baseline average peak blood flow velocities in IRAs were higher than those in non-IRAs after angioplasty (p <0.01) and at 1-week follow-up (p <0.01). However, at 6-month follow-up, uncorrected and corrected baseline average peak blood flow velocities in IRAs equaled values in
Discussion
This study demonstrates, in a homogenous cohort of patients with a first anterior wall AMI, increased levels of minimal microvascular resistance and decreased values of CFVR in IRAs and non-IRAs. Further, this study shows that microvascular function improved during 6-month follow-up in the 2 territories. Our study confirms previous observations that CFVR in IRA is decreased after reperfusion in the early phase of AMI secondary to a low hyperemic flow velocity.2, 3 Impairment of hyperemic flow
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