Abstract
Background and Objectives:The state of the coronary microcirculation is one of the major determinants of the prognosis of patients who have had successful reperfusion for acute myocardial infarction (AMI. We in- vestigated whether the vasodilatory reserve in the infarcted myocardium correlated with the perfusion state at early recovery phase in 12 anterior wall AMI patients. Materials and Method:We measured coronary flow variables with Doppler wire, after successful revascularizaiton by PTCA within 2 weeks following AMI and 13±0.5 months later, in the infarct related artery of AMI pts who received successful thrombolytic th- erapy. Myocardial perfuison state was evaluated by semiquantitative method (opacification score and opa- cification index with myocardial contrast echocardiography (MCE at the same time. Patients were divided into two groups according to initial perfusion status (perfusion defect group (PD (+ , n=7, no-perfusion defect group (PD(-, n=5. Results:10 minutes after completion of the intervention, the coronary flow reserve (CFR was 2.0±0.4 (mean±SD;it increased to 2.7±0.7 (p=0.002 at follow up. The difference of initial CFR was not significant between PD (+ and PD (- group. However, it significantly improved in the PD (- group compared to PD (+ group at follow up (3.19±0.39 vs. 2.39±0.7, p=0.046. Opacification index and initial CFR were significantly correlated (r=0.79, p<0.05. Conclusion:The perfusion state of infarcted myo- cardium was significantly correlated with coronary flow reserve in anterior wall AMI and CFR was significantly improved in patients with relatively preserved myocardial perfusion. (Korean Circulation J 1999;29(12 : 1289-1296
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