Page 21 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

General introduction and outline of the thesis
flow velocity with an intracoronary wire mounted with a Doppler crystal. 1 Dysfunctional microvasculature might among others be reflected by reversed
early systolic coronary flow, a steep deceleration slope of the diastolic flow
velocity, higher microvascular resistance and impaired CFR as quotient of hyperemic blood flow velocity and baseline blood flow velocity as indicator of recruitable functional microvascular capacity.66, 67
On the basis of the Doppler flow velocity studies of Kern et al. concluding that determination of flow velocity after reperfusion might enhance patient characterization and provide the physiological rationale for clinical variations after reperfusion therapy,64 we started our research in order to determine the post reperfusion microvascular changes over time as well as the relationship between microvascular dysfunction and the potential effects on left ventricular function recovery.
Aim of this thesis
The main aim of the studies presented in this thesis is to investigate the characteristics of coronary blood flow velocity rates reflecting coronary microvascular function during reperfusion of acute myocardial infarction and how these characteristics change over time in the post infarction phase. In addition, it was investigated whether patient characteristics, intervention or specific coronary microvasculature factors, insofar as they can be determined by intracoronary Doppler studies, may be predictive of left ventricular function recovery and long-term survival.
19