Page 174 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

Chapter 10
lesion to be physiological significant. The six-week interval for the detection of ischemia by CMR may be relevant, since the baseline and hyperemic blood flow will be less disturbed than in the acute phase of myocardial infarction, including remote areas. The time window might be shorter since CFC in non- IRA was near normal at 1-week post STEMI in our recent studies.
The results of the studies presented in this thesis indicate that one has to be careful with the interpretation of physiological measurements in non-culprit vessels during the acute phase of myocardial infarction. For the time being, the results of the COMPLETE trial are in favor of a staged procedure for non-culprit lesions in the weeks after AMI. At that time, the microcirculatory disturbances induced by AMI have been partly or completely resolved allowing to use physiological diagnostic techniques for the right decision making and avoiding unnecessary interventions.
Furthermore, extensive research into the long-term predictive value of impaired microvascular function in non-IRA at the time of STEMI is needed, as well as into the intervention options to improve microvascular function.
172