Early identification of impaired myocardial reperfusion with serial assessment of ST segments after percutaneous transluminal coronary angioplasty during acute myocardial infarction

<b>Does Coronary Artery Stenting for Acute Myocardial Infarction Improve Left Ventricular Overloading at the Chronic Stage?</b>

“…The results show that PTCA with stenting decreases the severity of left ventricular overloading during the chronic stage of myocardial infarction. The evaluation of extent-score maps [18][19][20] by myocardial scintigraphy using 99m Tc-tetrofosmin revealed that the area of decreased myocardial blood flow around the infarcted myocardium was significantly smaller after PTCA with stenting than after POBA, suggesting that stenting may contribute to the inhibition of decreased myocardial blood flow after reperfusion therapy.…”

Quantitative estimation of myocardial salvage after primary percutaneous transluminal coronary angioplasty in patients with angiographic no reflow

“…Thirty-six views every 5º were obtained for 25 s from 45º left posterior oblique to the 45º right anterior oblique. After correction for non-uniformity and centre of rotation, images were reconstructed into long-and short-axis cuts [10,14,15]. The study protocol was approved by the local ethical committee on human research.…”

“…Impaired myocardial reperfusion during PTCA was defined as a change (before minus after PTCA) of <4 in the defect score. Because mean absolute inter-observer variability in defect score was 2.0±0.8, an absolute change of ≥4 (mean+2 standard deviations) was considered to represent a significant difference between the two measurements using the cut-off value of score 4 [10,15].…”

“…However, myocardial contrast echocardiography can be performed only in limited investigational settings, mainly because of procedural complexity and poor image quality [3,4,18]. Serial scintigraphic imaging during acute MI is superior to myocardial contrast echocardiography because it may provide better image quality and permits quantitative assessment of the area at risk, infarct size and myocardial salvage [6,7,8,10,14,15]. Moreover, scintigraphic imaging can estimate residual antegrade flow before primary PTCA and collateral flow to the ischaemic area [7,8].…”

Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

“…[1][2][3][4][5][6][7] Earlier studies showed that STR at 30 minutes after PCI correlated better with other markers of myocardial perfusion than STR at 60 to 90 minutes. 12,13 However, the optimal time to measure STR after primary PCI is unknown. In addition, in case of suboptimal myocardial reperfusion, therapeutic options have to be considered as soon as possible, preferably during the PCI procedure.…”