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
published online 12 July 2007.
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.
Cardiology Department, Ain Shams University Hospital, Cairo, Egypt.
Reprint requests: Mohamed Abdel-Wahab, MD, Cardiology Department, Ain Shams University Hospital, Abbassia, Cairo, Egypt.
ABSTRACT