Reduced microvascular and myocardial damage in patients with acute myocardial infarction and preinfarction angina

Colonna, Paolo; Dessalvi, Christian Cadeddu; Montisci, Roberta; Ruscazio, Massimo; Selem, Abdel Hakem; Chen, Lijun; Onnis, E; Meloni, Luigi; Iliceto, Sabino

doi:10.1016/s0002-8703(02)80011-4

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…Severe ischemia resulting in transmural cellular necrosis may promote local responses, altering microvascular anatomy and function in the infarcted area, as reported in animal studies. The wellknown relationship between CFR and diabetes 37 was not documented in our study, in relation to the low incidence of diabetes.Furthermore, in contrast to previous studies,[38][39][40] hypertension, hypercholesterolemia, and preinfarction angina did not influence CFR in our selected patients with AMI, probably because ischemic microvascular damage was the strongest determinant of impaired CFR after reperfused AMI. After restored coronary patency, CFR explores the autoregulatory capabilities of the microcirculation and reflects the intrinsic microcirculatory abnormalities that occur as consequence of myocardial ischemia and reperfusion 36.…”

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confidence: 99%

Coronary flow reserve is related to the extension and transmurality of myocardial necrosis and predicts functional recovery after acute myocardial infarction

et al. 2019

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Background: Few studies have examined the effect of transmurality of myocardial necrosis on coronary microcirculation. The aim of this study was to examine the influence of cardiac magnetic resonance-derived (GE-MRI) structural determinants of coronary flow reserve (CFR) after anterior myocardial infarction (STEMI), and their predictive value on regional functional recovery. Methods:Noninvasive CFR and GE-MRI were studied in 37 anterior STEMI patients after primary coronary angioplasty. The wall motion score index in the left descending anterior coronary artery territory (A-WMSI) was calculated at admission and follow-up (FU). Recovery of regional left ventricular (LV) function was defined as the difference in A-WMSI at admission and FU. The necrosis score index (NSI) and transmurality score index (TSI) by GE-MRI were calculated in the risk area.Baseline (BMR) and hyperemic (HMR) microvascular resistance, arteriolar resistance index (ARI), and coronary resistance reserve (CRR) were calculated at the Doppler echocardiography.Results: Bivariate analysis indicated that the CPK and troponin I peak, heart rate, NSI, TSI, BMR, the ARI, and CRR were related to CFR. Multivariable analysis revealed that TSI was the only independent determinant of CFR. The CFR value of >2.27, identified as optimal by ROC analysis, was 77% specific and 73% sensitive with accuracy of 76% in identifying patients with functional recovery.Conclusions: Preservation of microvascular function after AMI is related to the extent of transmurality of myocardial necrosis, is an important factor influencing regional LV recovery, and can be monitored by noninvasive CFR. K E Y W O R D Sacute myocardial infarction, cardiac magnetic resonance imaging, coronary flow reserve, transthoracic echocardiography | 845 MONTISCI eT al.

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confidence: 99%

Coronary flow reserve is related to the extension and transmurality of myocardial necrosis and predicts functional recovery after acute myocardial infarction

et al. 2019

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“…There are several recent reports concerning the value of CFR measured transthoracically after reperfused acute anterior myocardial infarct [41,42]. In the study of Ueno et al [41] the decreased CFR <1,5 was identified to predict an increase in left ventricular volume (remodeling) after reperfused myocardial infarct.…”

Section: Reviewmentioning

confidence: 99%

“…A significant negative correlation was found between CFR and progression of left ventricular dilatation at 6-month follow-up. In the study of Colonna et al [42] it was shown that preconditioning due to preinfarction angina had a protective role on microvascular function as demonstrated by CFR preservation (>2,5) after myocardial infarct.…”

Section: Reviewmentioning

confidence: 99%

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Dimitrow

2003

Cardiovasc Ultrasound

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This review focuses on transthoracic Doppler echocardiography as noninvasive method used to assess coronary flow reserve (CFR) in a wide spectrum of clinical settings. Transthoracic Doppler echocardiography is rapidly gaining appreciation as popular tool to measure CFR both in stenosed and normal epicardial coronary arteries (predominantly in left anterior descending coronary artery). Post-stenotic CFR measurement is helpful in: functional assessment of moderate stenosis, detection of significant or critical stenosis, monitoring of restenosis after revascularization. In the absence of stenosis in the epicardial coronary artery, decreased CFR enable to detect impaired microvascular vasodilatation in: reperfused myocardial infarct, arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, syndrome X, hypertrophic cardiomyopathy. In these diseases, noninvasive transthoracic Doppler echocardiography allows for serial CFR evaluations to explore the effect of various pharmacological therapies.

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“…Previous studies with echocardiography had already shown the benefits of PIA in terms of increased myocardial viability, microvascular reflow [45,46], and better LVEF [13]. Previous studies with echocardiography had already shown the benefits of PIA in terms of increased myocardial viability, microvascular reflow [45,46], and better LVEF [13].…”

Section: Left Ventricular Ejection Fractionmentioning

confidence: 99%

Preinfarction angina

Luz

Santos

Rodrigues

et al. 2015

Coronary Artery Disease

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Reduced microvascular and myocardial damage in patients with acute myocardial infarction and preinfarction angina

Cited by 7 publications

References 25 publications

Coronary flow reserve is related to the extension and transmurality of myocardial necrosis and predicts functional recovery after acute myocardial infarction

Coronary flow reserve is related to the extension and transmurality of myocardial necrosis and predicts functional recovery after acute myocardial infarction

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Preinfarction angina

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