Key result
Anterior acute myocardial infarction was associated with significantly lower coronary sinus blood flow compared to healthy controls (287.8 vs 415 ml/min; p=0.001).
Why the study?
Does coronary sinus blood flow measured by transthoracic echocardiography correlate with left ventricular function and mortality in patients with anterior acute myocardial infarction?
Case-Control (n=40)
No
Does coronary sinus blood flow measured by transthoracic echocardiography correlate with left ventricular function and mortality in patients with anterior acute myocardial infarction?
Absolute Event Rate: 287.8% vs 415%
p-value: p=0.001
Coronary sinus blood flow and velocity time integral measured by transthoracic echocardiography are significantly reduced in anterior AMI and correlate well with LV systolic function and in-hospital mortality.
Reduced coronary sinus flow in anterior AMI was associated with worse LV function and mortality; hypothesis-generating and requires prospective validation before clinical adoption.
OBJECTIVE: To measure the coronary sinus blood flow (CSBF) and coronary sinus velocity time integral (CSVTI) via transthoracic echocardiography (TTE) in patients with acute myocardial infarction (AMI) in association with the left ventricular ejection fraction (LVEF), and wall motion scoring index (WMSI). METHODS: In this case-control study, 20 patients with anterior AMI and 20 healthy individuals as the control group, were studied in 6 months period from March to September 2005 in Madani Heart Center, Tabriz, Iran. All patients received the same treatment for AMI (such as fibrinolytic). The CSBF, CSVTI, WMSI, and tissue Doppler imaging (TDI) data were obtained via TTE and compared between the 2 groups. RESULTS: Baseline variables were similar between the 2 groups (p>0.05). The CSBF in AMI group was 287.8 +/- 128 ml/min and in the control group was 415 +/- 127 ml/min (p=0.001). Also, CSVTI was significantly lower in AMI group than control group (11.16 +/- 2.85 and 17.56 +/- 2.72 mm, p=0.003). There was a significant correlation between CSBF and LVEF (r=0.52, p=0.01), WMSI (r=-0.77, p=0.0001) and CSBF and in-hospital mortality (r=0.58 p=0.03), also between CSVTI and LVEF (r=0.85, p=0.0001), WMSI (r=-0.57, p=0.0009) and in-hospital mortality rate (r=0.69, p=0.02). The CSBF and CSVTI had a good correlation with TDI findings: peak early diastolic velocity in the myocardium and peak systolic velocity in the myocardium). CONCLUSION: Our study demonstrated a good correlation between measured CSBF and CSVTI by 2D- Doppler TTE and LVEF, WMSI, in-hospital mortality and TDI findings.
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Toufan et al. (2007) conducted a case-control in acute myocardial infarction (AMI) (n=40). Anterior acute myocardial infarction vs. Healthy individuals was evaluated on Coronary sinus blood flow (CSBF) (p=0.001). Anterior acute myocardial infarction was associated with significantly lower coronary sinus blood flow compared to healthy controls (287.8 vs 415 ml/min; p=0.001).
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