Coronary vasomotor function in infarcted and remote myocardium after primary percutaneous coronary intervention. Issue 19 (5th August 2015)

• Record Type: Journal Article
• Authors: Teunissen, Paul F A; Timmer, Stefan A J; Danad, Ibrahim; de Waard, Guus A; van de Ven, Peter M; Raijmakers, Pieter G; Lammertsma, Adriaan A; Van Rossum, Albert C; van Royen, Niels; Knaapen, Paul
• Is Part Of: Heart. Volume 101:Issue 19(2015)
• Page Start: 1577
• Page End: 1583
• Publication Date: 2015-08-05
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2015-307825
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: In patients with acute myocardial infarction (AMI), coronary vasomotor function is impaired in the myocardial territory supplied by the culprit artery and in remote myocardium supplied by angiographically normal vessels. The aim was to investigate the temporal evolution of coronary vasodilatory reserve in patients with AMI by use of [ 15 O]H2 O positron emission tomography, after successful percutaneous coronary intervention. Methods: 44 patients with AMI and successful revascularisation by percutaneous coronary intervention were included. Subjects were examined 1 week and 3 months after AMI with [ 15 O]H2 O positron emission tomography to assess the coronary flow reserve (CFR). CFR was defined as the ratio of myocardial blood flow (MBF) during hyperaemia and rest. Additionally, 45 age-matched and sex-matched subjects underwent similar scanning procedures and served as controls. Results: At baseline, CFR averaged 1.81±0.66 in infarcted myocardium versus 2.51±0.81 in remote myocardium (p<0.01). In comparison, CFR in the control group averaged 4.16±1.45 (p=0.001 vs both). During follow-up, the CFR increased to 2.74±0.85 in infarcted myocardium (p<0.01), and to 2.85±0.70 in remote myocardium (p<0.01). This was predominantly due to an increase in hyperaemic MBF, from 1.62±0.54 mL/min/g to 2.19±0.68 mL/min/g in infarcted myocardium (p<0.001), and 2.17±0.54 mL/min/g to 2.60±0.65 mL/min/g in remote myocardium (p<0.001). Conclusions: CFR in infarcted and remote myocardium is impaired 1 week after AMI. After 3 months vasomotor function partially recovers. However, as compared with control patients, MBF remains impaired in culprit and reference territories in patients with AMI. Clinical trial registration: NTR3164.