Key result
Patients with low coronary flow reserve (CFR ≤2) after a first AMI were significantly less likely to have myocardial viability compared to those with preserved CFR (2% vs 79%, P<0.0001).
Why the study?
Is low coronary flow reserve associated with reduced left ventricular systolic function and decreased myocardial viability in patients with a first acute myocardial infarction?
Observational (n=149)
Is low coronary flow reserve associated with reduced left ventricular systolic function and decreased myocardial viability in patients with a first acute myocardial infarction?
Absolute Event Rate: 2% vs 79%
p-value: p=<0.0001
In patients with a first acute myocardial infarction, reduced coronary flow reserve is strongly associated with compromised left ventricular longitudinal function and a lack of myocardial viability.
Low post-AMI CFR associates with absent viability; leaves open whether CFR assessment adds to viability testing.
AIMS: To investigate the relationships between coronary flow reserve (CFR), left ventricular (LV) systolic function, and myocardial viability in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: In 149 patients with a first AMI, we estimated CFR non-invasively and assessed LV systolic function with low-dose dobutamine Doppler echocardiography (LDDE), which also identified viability. Resting echocardiographic variables did not differ between patients with preserved (54.4%) and low CFR (45.6%). During LDDE, longitudinal LV function was decreased [9.5 cm/s (8;11.3) vs. 10.6 cm/s (8.5;12.5), P = 0.04] and end-systolic volume increased [49.5 mL (38;66) vs. 42 (31;61), P = 0.04] in patients with low compared with preserved CFR. Among 87 (58%) patients with resting wall motion abnormalities, 28 met the criteria for viability. One of 53 (2%) met the criteria for viability in patients with CFR < or =2 compared with 27 of 34 (79%) with CFR > 2, P < 0.0001. CONCLUSION: Resting echocardiographic parameters were similar in patient groups. During LDDE, patients with reduced CFR had increased LV size and compromised longitudinal function of LV and were less likely to have evidence of myocardial viability.
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Løgstrup et al. (2010) conducted an observational in Acute myocardial infarction (AMI) (n=149). Coronary flow reserve (CFR) assessment vs. Preserved CFR (CFR > 2) was evaluated on Myocardial viability (p=<0.0001). Patients with low coronary flow reserve (CFR ≤2) after a first AMI were significantly less likely to have myocardial viability compared to those with preserved CFR (2% vs 79%, P<0.0001).
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