Relationship Between Systolic Pulsed Wave Tissue Doppler Parameters and Both Invasive and Noninvasive Reperfusion Criteria in Patients with Acute Anterior Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Background

Despite normal flow in the infarct-related artery after primary percutaneous coronary intervention, patients may not achieve adequate perfusion at the tissue level. We examined the applicability of pulsed wave tissue Doppler (PTD) in detection of successful myocardial reperfusion.

Methods

In all, 24 patients with anterior infarction were enrolled. All patients underwent primary percutaneous coronary intervention. PTD was performed 2 days and 2 weeks after percutaneous coronary intervention, and recorded from 6 different locations at the mitral annular level. Peak systolic wave was determined and was related to various markers of reperfusion.

Results

Systolic PTD measurement in patients with myocardial blush grades 0 to 1 significantly deteriorated between second day and second week (6.5 ± 1.1-5.3 ± 1.1 for the anterior wall, and 6.2 ± 1.3-5.3 ± 1 for the anterior septum, P < .05 and P < .01, respectively). Systolic PTD parameters improved significantly in patients with myocardial blush grades 2 to 3 (6 ± 1.5-7.2 ± 2 for the anterior wall, and 5.4 ± 1.1-7.1 ± 1.6 for the anterior septum, P < .05 and P < .01, respectively). A significant relationship was observed between PTD and thrombolysis in myocardial infarction flow, S-T resolution, and creatine phosphokinase peaking. PTD recovery was highly sensitive and specific for the detection of left ventricular function recovery.

Conclusion

We demonstrated a significant relationship between systolic PTD parameters and invasive and noninvasive markers of reperfusion. Larger studies are needed to confirm these results.