Background/Aim No-reflow is a serious and frequent event during primary percutaneous coronary intervention (PPCI) for acute ST segment elevation myocardial infarction (STEMI). The aim of this study was to identify possible predictors for no-reflow. Patients and methods We investigated 218 patients with acute anterior STEMI who underwent PPCI from December 2016 to December 2018. No-reflow was defined as a coronary TIMI flow grade of � 2. TIMI flow grade 3 was defined as normal reflow. Results In our study, the no-reflow phenomenon was observed in 39 patients (18%) during angiography. The patients of no-reflow group were found to be more older, diabetics, longer pain-toballoon time, lower blood pressure, higher platelet counts and higher levels of D-Dimer and Cystatin C (Cys-C). In multivariate logistic regression analysis, only diabetes (OR = 0.371, 95% CI: 0.157-0.872, P = 0.023), longer pain-to-balloon time (OR = 1.147, 95% CI: 1.015-1.297, P = 0.028) and higher Cys-C level (OR = 10.07, 95% CI: 2.340-43.377, P = 0.002) were predictors for no-reflow. Conclusion Cys-C might be a useful predictor for the no-reflow phenomenon after PPCI in STEMI patients. It might help to screen STEMI patients with high risk of no-reflow on admission.
The aim of this study is to analyze the relption between myocardial oxygen consumption (MVOa and endsystolic volume (Em in dependence of adrenergic stimulation or blockade in the normal left ventricle. We analyzed M V a and volumetric data of fwe chroniEIlllp instrumented dogs measured during rest and exercise, while protoeohr were performed with and without beta-blockade.Then we constructed their overaU Alternative Starling Curve (ASC) by plotting ESV versus end-diitolic volume @DV). Subsequently, we carried out an adysh, while employing an extended model compared with the PressureVolume-Area (PVA) for M V G prediction as orkhaUy proposed by Suga. Thio mathematical model is validated by comparison with w e n t data obtaiied by labeled Gacetate PET studies in healthy humans.Our results indicate a dose resemblance h e e n theoretically predicted MVOz data and actual measurements performed in humans and dogd. In addition, thb study suggests neural modulation of the MV&-W relationship by illustrating the effects of various adrenergic interventions. I. INTRODUCI'IONMVO, is an important quantity in cardiology because an imbalance between ventricular oxygen supply and consumption implies deterioration of cardiac function. Unfortunately, direct measurement of M V q requires a complex procedum and is therefore not feasible in the clinical setting. Consequently, it would be helpful to device a method to predict MVO, on the basis of rather simple measurements. Substantial advancement in this respect has been made by Suga [I] by introducing the collcepf of the PVA which experimentally relates to MVO,. Subsequently, we further reduced the Sugawproach and derived an analytical expression in order to relate MV02 to HSV based on the concept of the Alternative Starling Curve (ASC)The ASC relates ESV to EDV and forms over a wi& range a linear relationship regardless of underlying pathology [2]. The slope of this regression line reflects neurohumoral regulation of the heart [2]. Thus, it may be anticipated that the ASC offers a suitable framework for studying neural modulation of M V q both during physiological (such as exercise) and under pathological circumstances. In this study we analyze data obtained in healthy dogs and validnk the redud PVA concept by using data collected in normal humans.' *) Dr. J-L J. Vanownchelde tr with rlic Udv. of Lowain Medical School in Bmsek, and Dr. GP. Qlmg tr d r h he Bo" sehwl of Me&cinc. WinsroksaLnn. NC. II. MBTHoDs using three orthogonal pairs of ultrasonic crystals in five chronically btsumented dogs, both ESV and EDV were estimated C3]. MVO, was determined by assessing myouudial blood flow in combination with mearmring differential arterial and co"ry sinus 02 content. Similarly, ESV and EDV in eight human volunteers were debmined by 'U)-echocardiography, while MVO, was calculated from 11C-acetate PET scan studies [4]. Based on these observations, we waluated the fonnalism to e q m MV02 as an explicit function of ESV. We applied linear r e g " , yielding the ASC as: ESV = a + fl EDV, where ...
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