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Usefulness of the index of microcirculatory resistance for invasively assessing myocardial viability immediately after primary angioplasty for anterior myocardial infarction.

Authors
Lim, HS; Yoon, MH; Tahk, SJ; Yang, HM; Choi, BJ; Choi, SY; Sheen, SS; Hwang, GS; Kang, SJ; Shin, JH
Citation
European heart journal, 30(23):2854-2860, 2009
Journal Title
European heart journal
ISSN
0195-668X1522-9645
Abstract
AIMS: The aim of this study is to evaluate the usefulness of the index of microcirculatory resistance (IMR) for predicting myocardial viability and left ventricular (LV) function recovery in acute myocardial infarction (AMI).



METHODS AND RESULTS: After successful primary percutaneous coronary intervention in 40 patients with anterior AMI, IMR was measured using a pressure-temperature sensor-tipped coronary guidewire. Myocardial viability was quantified by 18F-fluorodeoxyglucose (FDG) positron emission tomography in 38 patients. Echocardiographic regional wall motion was analysed to calculate the anterior wall motion score (A-WMS) and percent change in A-WMS after revascularization and at 6-month follow-up. IMR correlated significantly with regional myocardial FDG uptake (r = -0.738, P < 0.001) and it demonstrated significant correlation with percent change in A-WMS (r = -0.464, P = 0.003). The area under the receiver operating curve of IMR for predicting LV function recovery was 0.89 [95% CI 0.888-0.894].



CONCLUSION: Index of microcirculatory resistance, a new index representing microvascular integrity, is a reliable early on-site determinant of myocardial viability and LV recovery after primary stenting for AMI.
MeSH terms
AdultAgedAngioplasty, Balloon, Coronary*Anterior Wall Myocardial Infarction/physiopathologyAnterior Wall Myocardial Infarction/radionuclide imagingAnterior Wall Myocardial Infarction/therapy*Coronary Circulation/physiology*Coronary Vessels/physiopathologyCoronary Vessels/radionuclide imagingFemaleFluorodeoxyglucose F18/diagnostic useHeart/physiopathologyHeart/radionuclide imaging*HumansMaleMicrocirculation/physiologyMiddle AgedPositron-Emission TomographyRadiopharmaceuticals/diagnostic useTissue SurvivalVascular Resistance/physiology*Ventricular Function, Left/physiology
DOI
10.1093/eurheartj/ehp313
PMID
19684025
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
AJOU Authors
임, 홍석윤, 명호탁, 승제양, 형모최, 병주최, 소연신, 승수황, 교승강, 수진신, 준한
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