Prediction of Wall Motion Recovery From the Left Anterior Descending Coronary Artery Velocity Pattern Recorded by Transthoracic Doppler Echocardiography in Patients With Anterior Wall Myocardial Infarction : Retrospective and Prospective Studies

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• The diastolic deceleration slope of coronary flow velocity is steeper in patients with substantial 'no reflow' phenomenon than in those without it. This study investigated whether functional outcomes in patients with anterior wall acute myocardial infarction (AMI) can be predicted by analyzing the coronary flow velocity pattern recorded with transthoracic Doppler (TTD) echocardiography. Coronary blood flow velocity in the distal left anterior descending coronary artery was recorded with TTD at day-2 after primary percutaneous transluminal coronary angioplasty/Stent in 51 patients with anterior AMI and the diastolic deceleration half time (DHT, ms) was measured. The wall motion score index (WMSI) was measured at day-1 and-21. In the retrospective study, the DHT was much shorter in those with a poor outcome than in those with good outcome (152±109 vs 395±128 ms, p<0.05). Receiver-operating characteristic analysis documented that DHT≥300 ms is a suitable cut-off point (sensitivity of 83% and specificity of 93%). In the prospective study (n=30), ΔWMSI (dl-d21) was significantly higher in those with a DHT≥300 ms than those without (0.3±0.5 vs 1.6±0.7, p<0.001). DHT correlated significantly with ΔWMSI (dl-d21) (r=0.76, p<0.001). Patients with a shorter DHT of diastolic coronary flow velocity have a poorer functional outcome among patients with anterior AMI. The TTD-determined DHT is a useful predictor of myocardial viability after an anterior AMI.

• 社団法人日本循環器学会の論文
• 2001-07-20

著者

• HORI Masatsugu

  Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine

• Horio Masaru

  Ehime University

• 葛谷 恒彦

  国立循環器病センター 内科心臓血管 部門

• 葛谷 恒彦

  大阪大学

• Inoue Katsumi

  松江赤十字病院 循環器科

• Ito Hiroshi

  Division of Cardiology, Sakurabashi Watanabe Hospital

• Iwakura Katsuomi

  Division of Cardiology, Sakurabashi Watanabe Hospital

• Fujii Kenshi

  Division of Cardiology, Sakurabashi Watanabe Hospital

• Kamada Takenobu

  The First Department Of Medicine And The Department Of Medical Information Science

• Shintani Yasunori

  Division Of Cardiology Sakurabashi Watanabe Hospital

• MASUYAMA Tohru

  Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine

• Higashino Yorihiko

  Division Of Cardiology Sakurabashi Watanabe Hospital

• Fujii Kenshi

  Division Of Cardiology Sakurabashi Watanabe Hospital

• KUZUYA Tsunehiko

  Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine

• Masuyama Tohru

  Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine

• Sugimoto Ken

  Division of Cardiology,Sakurabashi Watanabe Hospital

• Kamada Takenobu

  The First Department Of Medicine Osaka University School Of Medicine

• Sugimoto Ken

  Division Of Cardiology Sakurabashi Watanabe Hospital

• Yamamoto Koichi

  Division of Cardiology, Sakurabashi Watanabe Hospital

• Kamada Takenobu

  1st Dept. Of Med. Medical School Osaka University

• Hamano Yutaka

  Division Of Cardiology Sakurabashi Watanabe Hospital

• KAMADA TAKENOBU

  Kaizuka Municipal Hospital

• Kuzuya Tsunehiko

  The First Department Of Medicine Osaka University Medicial School

• Hori Masatsugu

  Department Of Radiology National Center Hospital For Mental Nervous And Muscular Disorders National

• Matsuda Hikaru

  Osaka Medical Center For Cancer And Cardiovascular Disease

• Matsuda Hikaru

  Department Of Cardiology Osaka University Graduate School Of Medicine

• Iwakura Katsuomi

  Division Of Cardiology Sakurabashi Watanabe Hospital

• Hamano Y

  The First Dept Of Medicine Osaka University

• Horio Masaru

  Division Of Health Sciences Department Of Functional Diagnostic Science Osaka University Graduate Sc

• Hori Masatsugu

  Department Of Cardiology Ehime Prefectural Imabari Hospital

• Kuzuya Tsunehiko

  Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine

• Kuzuya Tsunehiko

  The Third Depertment Of Internal Medicine University Of Osaka

• Higashino Yorihiko

  Sakurabashi Watanabe Hospital And Ist. Dept. Of Med. Osaka Univ. School Of Med.

• Matsuda Hikaru

  香川大学 総合診療部

• Kazuya Tsunehiko

  The First Department Of Medicine Osaka University School Of Medicine

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