Distal coronary flow velocity immediately after direct angioplasty for acute myocardial infarction

Concordant improvements in coronary flow reserve and ST‐segment resolution during percutaneous coronary intervention for acute myocardial infarction: A benefit of postconditioning

“…A close relationship has been demonstrated between the extent of ST segment resolution and epicardial coronary arterial patency [26, 27] as well as tissue‐level myocardial perfusion [28, 29] during STEMI. A number of studies have described alterations in the Doppler‐derived pattern of coronary flow during PCI for STEMI as well as the predictive value of abnormal velocimetry, including assessment of CFVR [11–14, 30–34]. However, no studies have demonstrated the ability to favorably impact CFVR and/or the resolution of ST segment elevation.…”

“…The adequacy of myocardial perfusion following recanalization of an occluded epicardial coronary artery, as occurs during percutaneous coronary intervention (PCI) for an evolving ST segment elevation myocardial infarcation (STEMI), is a key determinant of short‐and long‐term clinical outcomes [1–5]. Given the importance of this measure, extensive efforts to define the adequacy of myocardial perfusion in this setting have focused on assessment of the latter by contrast angiography [6–8], ultrasound [2, 9, 10], Doppler velocimetry [11–14] and, most recently, magnetic resonance imaging [15, 16]. While quantitative differences may exist among these methods in assessing the extent of residual hypoperfusion, there is general agreement that, despite early and prompt recanalization of the epicardial coronary artery, there is inadequate myocardial‐level perfusion at the completion of the procedure in a significant number of patients [17].…”

The Coronary Slow Flow Phenomenon – A New Coronary Microvascular Disorder

“…Several studies have now reported coronary slow flow occurring immediately following an otherwise successful angioplasty and associated with severe rest pain, ECG changes and on occasions, myocardial infarction [9, 10, 11, 12]. It is of interest that ‘secondary coronary slow flow’ has been documented almost exclusively in patients undergoing urgent angioplasty for an acute coronary syndrome.…”

Magnetic Resonance Coronary Angiography in Patients with Ischemic Heart Disease. Analysis of Cornary Arterial Blood Flow Velocity Pattern.

“…In recent years, the development of the Doppler guidewire method facilitated the measurement of coronary blood flow in the peripheral stenotic region. [19][20][21][22][23] Nakamura, et al 24) and Heller, et al 25) reported that the diastolic peak blood flow velocity obtained by the Doppler guidewire method was significantly increased after PTCA. Consistent with their studies, our findings also indicate that the diastolic peak blood flow velocity obtained by MR coronary angiography was also significantly increased after PTCA.…”