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Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2.

2010Journal article Open access
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dc.contributor.authorSteigen, T
dc.contributor.authorChristopher, E
dc.contributor.authorBuller, C
dc.contributor.authorMancini, G
dc.contributor.authorJorapur, V
dc.contributor.authorCantor, W
dc.contributor.authorRankin, J
dc.contributor.authorThomas, B
dc.contributor.authorWebb, J
dc.contributor.authorKronsberg, S
dc.contributor.authorAtchison, D
dc.contributor.authorLamas, G
dc.contributor.authorHochman, J
dc.contributor.authorDzavík, V
dc.date.accessioned2012-12-20T12:40:45Z
dc.date.available2012-12-20T12:40:45Z
dc.date.issued2010
dc.description.abstractBACKGROUND: Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRAs) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. METHODS AND RESULTS: The Total Occlusion Study of Canada-2 enrolled stable patients with a persistently occluded IRA beyond 24 hours and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume as well as the change in MPG from immediate post-percutaneous coronary intervention (PCI) to 1 year in 139 PCI patients with thrombolysis in myocardial infarction grade 3 epicardial flow post-PCI and with paired values grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a left anterior descending IRA. They had lower blood pressure and LV ejection fraction (LVEF) and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were LVEF, 3.3±9.0% and 4.8±8.9% (P=0.42); LV end-systolic volume index (LVESVI), -1.1±9.2 and -4.7±12.3 mL/m(2) (P=0.25); LV end-diastolic volume index (LVEDVI), 0.08±19.1 and -2.4±22.2 mL/m(2) (P=0.67); and SDs/chord for infarct zone wall motion index (WMI), 0.38±0.70 and 0.84±1.11 (P=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (P<0.001), lower LVEF (P<0.001), and higher LVESVI (P<0.01) but not LVEDVI at 1 year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at 1 year. CONCLUSIONS: Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery, indicating that MPG determined in the subacute post-MI period remains a marker of viability.por
dc.identifier.citationCirc Cardiovasc Interv. 2010 Dec;3(6):549-55por
dc.identifier.issn1941-7632
dc.identifier.urihttp://hdl.handle.net/10400.10/823
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherLippincott Williams & Wilkinspor
dc.relation.publisherversionhttp://circinterventions.ahajournals.org/content/3/6/549.full.pdf+htmlpor
dc.subjectAcute coronary syndromepor
dc.subjectMyocardial infarctionpor
dc.subjectAngioplastypor
dc.titleMyocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceHagerstownpor
oaire.citation.endPage555por
oaire.citation.startPage549por
oaire.citation.titleCirculation. Cardiovascular Interventionspor
oaire.citation.volume3por
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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