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Titolo:
Postinfarctional remodeling: Increased dye intensity in the myocardial risk area after angioplasty of infarct-related coronary artery is associated with reduction of ventricular volumes
Autore:
Destro, G; Marino, P; Barbieri, E; Zorzi, A; Brighetti, G; Maines, M; Carletti, M; Zardini, P;
Indirizzi:
Univ Verona, Div Cardiol, I-37126 Verona, Italy Univ Verona Verona ItalyI-37126 ona, Div Cardiol, I-37126 Verona, Italy Univ Verona, Serv Cardiol, I-37126 Verona, Italy Univ Verona Verona Italy I-37126 na, Serv Cardiol, I-37126 Verona, Italy
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 5, volume: 37, anno: 2001,
pagine: 1239 - 1245
SICI:
0735-1097(200104)37:5<1239:PRIDII>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
NO-REFLOW PHENOMENON; CONTRAST ECHOCARDIOGRAPHY; FLOW RESERVE; PERFUSION; THROMBOLYSIS; REPERFUSION; VIABILITY; RECOVERY; DILATION; SIZE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Destro, G Univ Verona, Div Cardiol, P Stefani 1, I-37126 Verona, Italy Univ Verona P Stefani 1 Verona Italy I-37126 7126 Verona, Italy
Citazione:
G. Destro et al., "Postinfarctional remodeling: Increased dye intensity in the myocardial risk area after angioplasty of infarct-related coronary artery is associated with reduction of ventricular volumes", J AM COL C, 37(5), 2001, pp. 1239-1245

Abstract

OBJECTIVES We sought to evaluate if angiographic dye videointensity of therisk area during percutaneous transluminal coronary angioplasty (PTCA) of the infarct-related artery (IRA) relates to remodeling. BACKGROUND Poor reflow after myocardial infarction (MI) predicts worse ventricular remodeling. METHODS Fifty-three patients with a first anterior MI and isolated diseaseof the left anterior descending (LAD), who underwent "primary" (n = 14), rescue"(n=7) or "late" (after 10 +/- 4 days, n = 32) PTCA, were retrospectively selected. In 10 patients prospectively collected, we assessed Doppler flow velocities and Doppler flow reserve (DFR), relating them to the videointensity technique. Coronary stenosis and TIMI flow were determined, and echocardiographic volumes (end-diastolic and end-systolic volume indexes) and regional asynergy were computed before hospital discharge (baseline) and atsix months. Assuming higher peak videointensity reflects greater myocardial blood volume, a 1- to 5-point (poor-optimal) perfusion scale was devised. RESULTS The correlation of Doppler peak velocity and DFR with videointensity was significant (r = 0.58, p = 0.007 and r = 0.71, p < 0.001, respectively). Patients were subdivided into group A (increased videointensity post-PTCA <greater than or equal to>1.5 points, n = 29) and group B (unchanged videointensity, n = 24). Analysis of variance showed a time-group interactionfor end-diastolic volume index (-4.6 +/- 23% vs. +22 +/- 22%, p = 0.003) and end-systolic volume index (-3.05 +/- 11.1% vs. +4.1 +/- 12.5%, p = 0.027). There was no interaction for changes in LAD stenosis (p = 0.39) and TIMIflow after PTCA (p = 0.27), or regional asynergy at six months (p = 0.31). CONCLUSIONS Angiographic dye videointensity in the risk area correlates with Doppler peak velocity and DFR, and its increase after PTCA of IRA has a limiting effect on ventricular volumes, independent of coronary stenosis resolution, changes in Thrombolysis In Myocardial Infarction (TIMI) flow or extent of regional asynergy. (J Am Coil Cardiol 2001;37: 1239-45) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 16:20:51