Abnormal coronary flow reserve (<2) at 3 weeks post-myocardial infarction was associated with a significantly greater increase in left ventricular end-systolic volume at 6 months compared to normal reserve (11.8% vs -8.7%, p=0.015).
Cohort (n=37)
Yes
Does normal coronary flow reserve in the convalescent stage predict favorable late myocardial morphologic changes in patients with first anterior AMI?
Normal microvascular function (CFR >= 2) in the convalescent stage post-AMI is associated with favorable late left ventricular remodeling.
Absolute Event Rate: 11.8% vs -8.7%
p-value: p=0.015
BACKGROUND: Microvascular damage immediately after reperfusion therapy is an independent predictor of left ventricular function in patients with acute myocardial infarction (AMI). However, its recovery may vary among individuals and the relationship between convalescent stage microvasculature and late myocardial morphologic change is unclear. METHODS AND RESULTS: Patients treated with coronary angioplasty within 12 h of their first anterior AMI were enrolled in this study. Coronary flow reserve (CFR) was measured 3 weeks post AMI, in both branches of the left coronary artery: culprit (left anterior descending artery: LAD) and non-culprit (left circumflex artery: LCX). Left ventriculography was performed at 3 weeks and 6 months post AMI and compared. Seventeen patients showed abnormal CFR in the LAD (Group 1: CFR/=2). Percent changes of end-diastolic volume tended to be higher in Group 1 than in Group 2 (11.8+/-21.6% vs -1.3+/-14.4%, p=0.056), and %changes of end-systolic volume was significantly smaller in Group 2 (11.8+/-22.1% vs -8.7+/-25.1%, p<0.05). A statistically significant correlation was found between absolute and relative CFR in the LAD and %change of end-systolic volume (r=-0.58: p<0.001, and r=0.40: p<0.05, respectively). CONCLUSIONS: Microvascular function in the convalescent stage may be related to these favorable changes.
Shimada et al. (Thu,) conducted a cohort in First anterior acute myocardial infarction (n=37). Abnormal coronary flow reserve (CFR < 2) vs. Normal coronary flow reserve (CFR ≥ 2) was evaluated on Percent change in left ventricular end-systolic volume (% ∆ESV) at 6 months (p=0.015). Abnormal coronary flow reserve (<2) at 3 weeks post-myocardial infarction was associated with a significantly greater increase in left ventricular end-systolic volume at 6 months compared to normal reserve (11.8% vs -8.7%, p=0.015).