Title
Impaired coronary flow reserve after a recent myocardial infarction : correlation with infarct size and extent of microvascular obstruction Impaired coronary flow reserve after a recent myocardial infarction : correlation with infarct size and extent of microvascular obstruction
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Amsterdam ,
Subject
Human medicine
Source (journal)
International journal of cardiology. - Amsterdam, 1981, currens
Volume/pages
167(2013) :2 , p. 351-356
ISSN
0167-5273
ISI
000320768800018
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background The exact relationship between the coronary flow reserve (CFR) and infarct size remains unknown. In this prospective study the relationship between the CFR both in the infarcted and remote myocardium and infarct size was investigated. Furthermore, the diagnostic value of the CFR to predict the extent of microvascular obstruction (MO) was evaluated. Methods In thirty patients the CFR was measured with a Doppler guide wire 6 ± 3 days after a first myocardial infarction (MI) in the infarct related and in a reference coronary artery. MO and infarct size were determined with magnetic resonance imaging. Results The CFR was inversely related to infarct size in the infarcted and remote myocardium (respectively, r = − 0.60, p < 0.01 and r = − 0.62, p < 0.01). In the infarcted myocardium the extent of MO was strongly related to the infarct size and was in a multivariate analysis the single significant determinant of the CFR and the hyperaemic flow. In the remote myocardium no relationship was present between infarct size and hyperaemic flow, but the baseline flow increased as the infarct size became larger (r = 0.58, p < 0.01). In a receiver operator characteristic (ROC) analysis, a CFR value ≤ 2 in the infarct related coronary artery offered the best sensitivity (65%) and specificity (71%) to detect the presence of MO (p < 0.05). Conclusions After MI, the CFR both in the infarcted and remote myocardium is inversely related to infarct size. In the infarcted myocardium, a CFR value ≤ 2 predicts the presence of MO with moderate sensitivity and specificity.
E-info
https://repository.uantwerpen.be/docman/iruaauth/ec545e/00a4473.pdf
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