Page 43 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

coronary flow velocity patterns in contrast with CFR. Surprisingly, CFR was not
assessed in the aforementioned studies. Although altered flow patterns after
primary PCI could predict in-hospital complications and mortality,23 it is unclear
if these flow patterns can predict also long-term mortality. 2
Study limitations
This study was designed to evaluate prognostic parameters obtained during primary PCI on LV function recovery. The present study indicates that CFR is a good prognostic parameter for LV function recovery, although larger studies are needed for evaluation of Doppler-derived parameters to predict mortality. In this study we did not perform intracoronary pressure measurements with microvascular resistance calculations. Combined and repeated coronary flow and pressure assessment in the early and late phase of MI may give more insight into changes in microvascular resistance in relation to LV function recovery.
Clinical implications
Our study suggests that CFR immediately after primary PCI can predict LV function recovery. This finding is relevant for selection of patients that may benefit from adjunctive therapies aiming at improving tissue reperfusion and, hence, recovery of LV function.
Conclusions
Percutaneous coronary intervention in patients with acute MI reduces infarct size and preserves LV function. Preservation of the microvascular function, and thus, of the integrity of myocardial tissue, is the pivotal factor influencing recovery of LV function after primary PCI. This study demonstrates that Doppler derived CFR better predicts recovery of LV function than the commonly reported angiographic and clinical parameters
Acknowledgments
We thank the technical and nursing staff of our cardiac catheterization laboratory and coronary care unit for skilled assistance.
Prediction of recovery of LV function
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