Do Indices of Coronary Conductance After Reperfusion Reflect the Extent of Salvaged Myocardium?
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概要
- 論文の詳細を見る
Existing indices of coronary conductance (hyperemic flow-versus-pressure slope index, FPSI, and zero flow pressure, Pzf) have been developed as measures of microcoronary resistance. These indices, however, refer to cases of normal hearts, and there are no reports studying these indices following acute myocardial infarction. In this study, we investigated whether FPSI and Pzf truly measure the extent of myocardial salvage after successful reperfusion therapy. We also developed a new index of zero pressure flow, Fzp. Nineteen patients who underwent successful reperfusion therapy to the proximal portion of the left anterior descending artery (LAD) were studied. After successful reperfusion therapy, a Doppler wire was placed into the LAD. Aortic pressure was recorded in real time. Results from the aortic pressure and flow meter were combined to produce FPSI, Pzf, and Fzp. All cases underwent a resting thallium (Tl) and BMIPP scintigram within five days of successful reperfusion therapy. Infarcted myocardium was estimated using a severity score calculated from the Tl scintigraphy (TlSS), and the BMIPP (BMIPPSS) was estimated using a severity score. Patients with a TlSS/BMIPPSS ratio of less than 0.4 were assigned to the successful salvage group (group S), while the others were assigned to the failed salvage group (group F). FPSI of group F was 1.91 ± 0.26 m/sec and of group S was 0.92 ± 0.43 m/sec (P < 0.01). Pzf of group F was 51 ± 3 mmHg and of group S was 51 ± 5 mmHg (NS). Fzp of group F was -98 ± 16 cm/sec and of group S was -46 ± 4 cm/sec (P < 0.05). FPSI and the new index of Fzp were useful in estimating the extent of myocardial salvage. Our results suggest that the Pzf index could not differentiate between the two groups.
- International Heart Journal刊行会の論文
著者
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Imai Kamon
Department of Cardiology, Saitama Cardiovascular Respiratory Center
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Horie Toshinobu
Department of Cardiology, Saitama Cardiovascular Respiratory Center
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Mutou Makoto
Department of Cardiology, Saitama Cardiovascular and Respiratory Center
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SHIBATA Takahiro
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Imai Kamon
Department Of Cardiology Saitama Cardiovascular And Respiratory Center
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Mochizuki Seibu
Division Of Cardiology Department Of Internal Medicine Jikei Univerisity School Of Medicine
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Horie Toshinobu
Department Of Cardiology Saitama Cardiovascular And Respiratory Center
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Iwano Keiji
Division Of Cardiology Department Of Internal Medicine The Jikei University School Of Medicine
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Ogawa Takayuki
Division Of Cardiology Department Of Internal Medicine The Jikei University School Of Medicine
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Minai Kousuke
Division of Cardiology, Department of Internal Medicine, Jikei University Kashiwa Hospital
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Watanabe Hisashi
Division Of Cardiology Department Of Internal Medicine The Jikei University School Of Medicine
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Shibata Takahiro
Division Of Cardiology Department Of Internal Medicine Jikei University School Of Medicine
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Ogawa Takayuki
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Mutou Makoto
Department of Cardiology, Saitama Cardiovascular Respiratory Center
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Tsurusaki Tetsushi
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Tamura Tetsutarou
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Yoshida Satoshi
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Iwano Keiji
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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Minai Kousuke
Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine
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