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Coronary Flow Velocity Accurate Indicator In Acute Myocardial Infarction
A DGReview of :"Coronary flow velocity pattern immediately after percutaneous coronary intervention as a predictor of complications and in-hospital survival after acute myocardial infarction."
Circulation
12/17/2002
By Harvey McConnell
Coronary flow velocity pattern (CFV) appears to produce an accurate prediction of both complications, as well as in-hospital-survival among patients who suffer an acute myocardial infarction (AMI).
The study was undertaken by clinicians at the Division of Cardiology, Kobe General Hospital, Kobe, Japan, in light of a recent report that the degree of microvascular injury and left ventricular functional recovery during the chronic period can be predicted after treatment of the infarct-related artery based on the coronary flow velocity (CFV) pattern assessed using a Doppler guide wire.
They enrolled 169 consecutive patients who had had a first anterior AMI successfully treated with percutaneous coronary intervention (PCI).
The CFV pattern among the patients immediately after PCI was examined using a Doppler guide wire. Clinicians defined severe microvascular injury as a diastolic deceleration time less than or equal to 600 ms, and the presence of systolic flow reversal. This was done in line with previous findings.
Clinicians divided the patients into two group. Group 1 was made up of 118 patients without severe microvascular injury, and Group 2 comprised 51 patients with severe microvascular injury. All of the patients who had cardiac rupture were contained in Group 2.
Clinicians found that congestive heart failure was more frequent among patients in Group 2 (53 percent) than among patients in Group 1 (eight percent; p < 0.001). In addition, the cardiac mortality rate was 18 percent in group 2 versus 0 percent among patients in Group 1 . Among the nine patients in group 2 who died, five were caused by congestive heart failure and four by cardiac rupture.
Circulation 2002; Dec 10;106(24):3051-6.
"Coronary flow velocity pattern immediately after percutaneous coronary intervention as a predictor of complications and in-hospital survival after acute myocardial infarction."
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