938-57 Coronary Flow Velocity Immediately After Successful Direct Coronary Angioplasty Predicts Recovery of Regional Wall Motion in Acute Myocardial Infarction

Abstract

To predict the recovery of left ventricular regional wall motion after successful direct angioplasty in acute myocardial infarction, we measured coronary flow velocity variables using Doppler guidewire (FloWire) immediately after reperfusion in 22 patients (pts) (14LAD, 8RCA) and compared them with left ventriculographic indices. Average peak velocity (cm/sec; mean ± SD) was 17.6 ± 8.0, average diastolic peak velocity (em/sec; mean ± SD) was 21.7 ± 10.6 and diastolic systolic velocity ratio (DSVR) was 2.1 ± 1.0. Patients were divided into 2 groups based on DSVR (normal DSVR: LAD > 1.7, RCA > 1.4). There were no significant differences between 2 groups in peak CPK, elapsed time and collateral flow grade. Left ventricular ejection fraction (EF) and regional wall motion (RWM) by left ventriculogram on admission and at discharge were compared between normal DSVR group (n = 15; 10LAD, 5RCA) and low DSVR group (n = 7; 4LAD, 3RCA). RWM (SD/chord) Normal DSVR (n = 15) Low DSVR (n = 7) p-value on admission -30 ± 0.7 -25 ± 0.5 NS at discharge -2.0 ± 1.0 -2.0 ± 0.6 NS ΔRWM EF(%) 1.0 ± 0.4 0.5 ± 0.4 < 0.05 on admission 48 ± 13 53 ± 6 NS at discharge 62 ± 11 52 ± 10 NS ΔEF 14 ± 6 -1 ± 9 < 0.05 Measurements of coronary flow velocity immediately after direct coronary angioplasty predict the recovery of regional and global left ventricular function in pts with acute myocardial infarction