Combined assessment of reflow and collateral blood flow by myocardial contrast echocardiography after acute reperfused myocardial infarction.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9602087 Publication Model: Print Cited Medium: Print ISSN: 1355-6037 (Print) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BMJ Pub. Group, c1996-
    • Subject Terms:
      Collateral Circulation* ; Coronary Circulation* ; Echocardiography*; Myocardial Infarction/*physiopathology; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cardiotonic Agents/therapeutic use ; Dobutamine ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/therapy ; Prognosis
    • Abstract:
      Objective: To evaluate the combined assessment of reflow and collateral blood flow by myocardial contrast echocardiography after myocardial infarction.
      Design: Myocardial contrast echocardiography was performed in patients with acute myocardial infarction shortly after successful coronary reperfusion (TIMI 3 patency) by direct angioplasty. Collateral flow was assessed before coronary angioplasty, and contrast reflow was evaluated 15 minutes after reperfusion. The presence of contractile reserve was assessed by low dose dobutamine echocardiography (5 to 15 micrograms/kg/min) at (mean (SD)) 3 (2) days after myocardial infarction. Recovery of segmental function (myocardial viability) was evaluated by resting echocardiography at a two month follow up. The study was prospective.
      Patients: 35 consecutive patients referred for acute transmural myocardial infarction.
      Results: Contrast reflow was observed in 20 patients (57%) and collateral flow in 14 (40%). Contrast reflow and collateral contrast flow were both correlated with reversible dysfunction on initial dobutamine echocardiography and at follow up (p < 0.05). The presence of reflow or collateral flow on myocardial contrast echocardiography was a highly sensitive (100%) but weakly specific (60%) indicator of segmental dysfunction recovery. Simultaneous presence of contrast reflow and collateral flow was more specific of reversible dysfunction than reflow alone (90% v 60%).
      Conclusions: Combined assessment of reflow and collateral blood flow enhanced the sensitivity of myocardial contrast echocardiography in predicting myocardial viability after acute, reperfused myocardial infarction. The simultaneous presence of reflow and collateral blood flow was highly specific of recovery of segmental dysfunction.
    • References:
      Circ Res. 1966 Jul;19(1):57-62. (PMID: 5912914)
      Lancet. 1998 Mar 14;351(9105):815-9. (PMID: 9519973)
      Am J Cardiol. 1978 Aug;42(2):234-43. (PMID: 685837)
      Am J Cardiol. 1985 May 1;55(11):1259-63. (PMID: 3993556)
      Circulation. 1986 Sep;74(3):469-76. (PMID: 2943529)
      Circulation. 1987 Jun;75(6):1249-60. (PMID: 3032476)
      Am J Cardiol. 1987 Jul 1;60(1):166-71. (PMID: 3604933)
      J Am Coll Cardiol. 1988 Jan;11(1):59-65. (PMID: 3335707)
      Br Heart J. 1988 Jan;59(1):20-2. (PMID: 3342145)
      J Am Coll Cardiol. 1989 Jul;14(1):58-64. (PMID: 2500472)
      J Am Soc Echocardiogr. 1989 Sep-Oct;2(5):358-67. (PMID: 2698218)
      J Am Coll Cardiol. 1990 Sep;16(3):695-704. (PMID: 2387943)
      Am J Cardiol. 1990 Sep 1;66(5):556-61. (PMID: 2392976)
      J Am Coll Cardiol. 1992 Jan;19(1):1-10. (PMID: 1729317)
      Circulation. 1992 May;85(5):1699-705. (PMID: 1572028)
      Circulation. 1992 Jun;85(6):2080-9. (PMID: 1591827)
      N Engl J Med. 1992 Dec 24;327(26):1825-31. (PMID: 1448120)
      Circulation. 1993 Aug;88(2):405-15. (PMID: 8339404)
      Circulation. 1993 Dec;88(6):2596-606. (PMID: 8252670)
      Circulation. 1994 Jun;89(6):2562-9. (PMID: 8205665)
      Lancet. 1994 Oct 29;344(8931):1190-2. (PMID: 7934540)
      Circulation. 1995 Feb 1;91(3):656-62. (PMID: 7828290)
      Am J Cardiol. 1995 Feb 1;75(4):215-9. (PMID: 7832125)
      Am J Cardiol. 1995 Nov 1;76(12):861-8. (PMID: 7484821)
      Circulation. 1995 Nov 15;92(10):2863-8. (PMID: 7586253)
      Circulation. 1996 Jan 15;93(2):223-8. (PMID: 8548892)
      Am J Cardiol. 1996 Mar 1;77(7):441-5. (PMID: 8629581)
      Eur Heart J. 1996 Mar;17(3):344-53. (PMID: 8737209)
      Eur Heart J. 1996 Feb;17(2):296-301. (PMID: 8732385)
      Eur Heart J. 1995 Nov;16 Suppl M:17-23. (PMID: 8869119)
      J Am Coll Cardiol. 1996 Dec;28(7):1677-83. (PMID: 8962551)
      Eur Heart J. 1997 Apr;18(4):618-24. (PMID: 9129892)
      Eur Heart J. 1997 May;18(5):771-9. (PMID: 9152647)
      Eur Heart J. 1997 Jun;18 Suppl D:D124-9. (PMID: 9183621)
      Am J Cardiol. 1997 Jul 1;80(1):6-10. (PMID: 9205011)
      Circulation. 1997 Aug 5;96(3):785-92. (PMID: 9264483)
      J Am Coll Cardiol. 1997 Nov 1;30(5):1399-406. (PMID: 9350946)
      J Clin Invest. 1974 Dec;54(6):1496-508. (PMID: 4140198)
    • Accession Number:
      0 (Cardiotonic Agents)
      3S12J47372 (Dobutamine)
    • Publication Date:
      Date Created: 19990623 Date Completed: 19990804 Latest Revision: 20190503
    • Publication Date:
      20221213
    • Accession Number:
      PMC1729108
    • Accession Number:
      10.1136/hrt.82.1.62
    • Accession Number:
      10377311