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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
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Published on: June 28, 2019

Coronary microcirculatory dysfunction is associated with left ventricular dysfunction during follow-up after STEMI.

M Remmelink1, K D Sjauw, Z Y Yong

  • 1Department of Cardiology, Academic Medical Centre-University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands, m.remmelink@amc.uva.nl.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|February 21, 2013
PubMed
Summary

Following ST-elevation myocardial infarction (STEMI) treated with PCI, impaired left ventricular (LV) function is linked to reduced coronary microvascular resistance variability. Larger infarcts cause higher baseline flow in compromised LV. Keywords: STEMI, LV function, coronary microcirculation.

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12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Interventional Cardiology

Background:

  • Coronary microvascular resistance (MVR) increases post-primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).
  • Left ventricular (LV) dynamics may influence this MVR change.
  • Understanding the relationship between LV function and coronary microcirculation post-STEMI is crucial.

Purpose of the Study:

  • To investigate the relationship between coronary microcirculation and systolic/diastolic LV function after STEMI.
  • To assess how LV dynamics affect coronary microvascular resistance in STEMI patients.

Main Methods:

  • A cohort of 12 patients with anterior STEMI treated with primary PCI was studied.
  • Pressure-volume loops, intracoronary pressure, and flow velocity were measured 4 months post-PCI.
  • Coronary microvascular resistance, infarct size, and LV mass were calculated/assessed using MRI and invasive measurements.

Main Results:

  • Patients with impaired systolic LV function (larger infarcts) had higher baseline average peak flow velocity (APV) and impaired microvascular resistance index.
  • Impaired diastolic relaxation correlated inversely with hyperemic APV and positively with hyperemic microvascular resistance.
  • LV dilatation was associated with a reduced microvascular resistance index.

Conclusions:

  • Larger anterior myocardial infarctions lead to impaired LV performance.
  • This impairment is associated with reduced coronary microvascular resistance variability.
  • Higher baseline coronary blood flow in compromised left ventricles contributes to this reduced variability.