PMID- 10732893
OWN - NLM
STAT- MEDLINE
DCOM- 20000331
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 35
IP  - 4
DP  - 2000 Mar 15
TI  - Pressure-derived fractional collateral blood flow: a primary determinant of left 
      ventricular recovery after reperfused acute myocardial infarction.
PG  - 949-55
AB  - OBJECTIVES: We evaluated the relation between pressure-derived fractional 
      collateral flow (PDCF) and left ventricular (LV) recovery after reperfused acute 
      myocardial infarction (AMI). BACKGROUND: The functional significance of 
      collateral flow remains uncertain in AMI. METHODS: The PDCF was measured in 70 
      patients with first AMI (pain onset <12 h) treated with primary angioplasty (PA), 
      being determined by simultaneous measurement of mean aorta pressure (Pa), distal 
      coronary pressure during the balloon occlusion (Poc), and central venous pressure 
      (CVP): (Poc - CVP)/(Pa - CVP)*100. Sufficient collateral (group I) was defined as 
      PDCF index >24% and insufficient collateral (group II) as PDCF index <24%. 
      Echocardiography was performed before, and on day 3, day 7, and day 30 after PA. 
      Wall-motion recovery index (RI) was obtained by dividing the number of improved 
      wall-motion segments (>grade 1) at follow-up by the number of abnormal 
      wall-motion segments within the infarct zone at baseline. RESULTS: Baseline 
      characteristics were similar between both groups. Peak levels of creatine kinase 
      were lower in group I than in group II (2,600+/-1,900 U/liter vs. 4,100+/-3,000, 
      p < 0.05). At one month, infarct zone wall-motion score index (1.65+/-0.54 vs. 
      2.31+/-0.46, p < 0.01) and LV volume indexes were smaller in group I than in 
      group II, whereas, LV ejection fraction was higher in group I than in group II 
      (52.8+/-8.3 vs. 45.9+/-9.0, p < 0.01). The PDCF index was the strongest predictor 
      of RI at one month (r = 0.61, p < 0.01). Time to reperfusion was not related to 
      RI at one month. However, it was significantly related to RI in group II (r = 
      -0.34, p < 0.05). CONCLUSIONS: The LV recovery after reperfused AMI is primarily 
      determined by PDCF and is less dependent on time to reperfusion in patients with 
      sufficient collaterals.
FAU - Lee, C W
AU  - Lee CW
AD  - Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
FAU - Park, S W
AU  - Park SW
FAU - Cho, G Y
AU  - Cho GY
FAU - Hong, M K
AU  - Hong MK
FAU - Kim, J J
AU  - Kim JJ
FAU - Kang, D H
AU  - Kang DH
FAU - Song, J K
AU  - Song JK
FAU - Lee, H J
AU  - Lee HJ
FAU - Park, S J
AU  - Park SJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - EC 2.7.3.2 (Creatine Kinase)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angioplasty, Balloon, Coronary
MH  - Blood Pressure/*physiology
MH  - Collateral Circulation/physiology
MH  - Coronary Circulation/*physiology
MH  - Creatine Kinase/blood
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Myocardial Infarction/*physiopathology/therapy
MH  - Myocardial Reperfusion Injury/*physiopathology/therapy
MH  - Prognosis
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*physiopathology/therapy
MH  - Ventricular Function, Left/*physiology
EDAT- 2000/03/25 00:00
MHDA- 2000/03/25 00:01
CRDT- 2000/03/25 00:00
PHST- 2000/03/25 00:00 [pubmed]
PHST- 2000/03/25 00:01 [medline]
PHST- 2000/03/25 00:00 [entrez]
AID - S073510979900649X [pii]
AID - 10.1016/s0735-1097(99)00649-x [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2000 Mar 15;35(4):949-55. doi: 10.1016/s0735-1097(99)00649-x.