2004
DOI: 10.1161/01.cir.0000118496.44135.a7
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Impact of Microvascular Dysfunction on Left Ventricular Remodeling and Long-Term Clinical Outcome After Primary Coronary Angioplasty for Acute Myocardial Infarction

Abstract: Background-We hypothesized that preserved microvascular integrity in the area at risk would favorably influence left ventricular (LV) remodeling and long-term outcome after acute myocardial infarction. Methods and Results-Before and after successful primary angioplasty (percutaneous transluminal coronary angioplasty[PTCA]), 124 patients with acute myocardial infarction underwent intracoronary myocardial contrast echo (MCE). An MCE score index (MCESI) was derived by averaging the single-segment score (0ϭnot vis… Show more

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Cited by 386 publications
(262 citation statements)
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“…The use of gated SPECT to assess left ventricular function from perfusion data is the innovative methodological contribution of this study. Although area at risk and final infarct size are considered reliable surrogate end-points for studies comparing different treatment strategies in acute myocardial infarction [22], the prognostic implications of left ventricular ejection fraction and left ventricular volumes are well known [23][24][25]. Gated SPECT could be particularly advantageous for this kind of study, given that it allows reproducible assessment of both perfusion and functional changes [2-5, 16, 17, 26].…”
Section: Discussionmentioning
confidence: 99%
“…The use of gated SPECT to assess left ventricular function from perfusion data is the innovative methodological contribution of this study. Although area at risk and final infarct size are considered reliable surrogate end-points for studies comparing different treatment strategies in acute myocardial infarction [22], the prognostic implications of left ventricular ejection fraction and left ventricular volumes are well known [23][24][25]. Gated SPECT could be particularly advantageous for this kind of study, given that it allows reproducible assessment of both perfusion and functional changes [2-5, 16, 17, 26].…”
Section: Discussionmentioning
confidence: 99%
“…17 Dilation portends a poor long-term outcome. Prior evidence for an association between persistent IRA occlusion and late-phase LV remodeling, 18 characterized by increased contractile segment length and change in shape toward the spherical, 19 is more robust than the evidence for the association of IRA status and global LV systolic function.…”
Section: Džavík Et Al Total Occlusion Study Of Canada-2mentioning
confidence: 99%
“…39 MCE detected CMVO was associated with an enhancement of the risk of adverse remodelling at 6 months 33 and of cardiac death after 46 months. 40 CMR detected CMVO increased the risk of adverse remodelling at 6 months 41 and of death. 42 The lack of STR Coronary microvascular obstruction raised the risk of total mortality after 30 days but failed to predict adverse left ventricular remodelling.…”
Section: Prognosis Of Coronary Microvascular Obstructionmentioning
confidence: 92%
“…21,[36][37][38][39][40][41][42][43] In particular, TIMI flow ≤2 is associated with an increased risk of adverse remodelling at 6 months 36 and of 5-year mortality. 37 MBG 0-1 raised the risk of adverse remodelling at 6 months 38 and of total mortality after 16 months of follow-up.…”
Section: Prognosis Of Coronary Microvascular Obstructionmentioning
confidence: 99%