Title: Relation between Perfusion Status of Dysfunctional Myocardium and Coronary Flow Reserve in Acute Myocardial Infarction
Abstract: Background:Dysfunction of microvasculature was frequently observed despite of successful revascularization with alteration of coronary flow dynamics in acute myocardial infarction(AMI. Reduction of coronary vasodilatory reserve was found in poorly perfused infarcted myocardium. The objectives of this study was to evaluate the vasodilatory reserve in infarcted myocardium and determined its relationship to perfusion status of myocardium in early recovery phase of acute myocardial infarction. Method:The study subjects consisted of 14 patients with anterior AMI and 6 controls with atypical chest pain and have normal coronary artery. The coronary flow pattern was assessed using intracoronary Doppler wire and vasodilatory reserve was measured after injection of 18μ g of adenosine to infarct-related artery after successful revascularization by percutaneous angioplasty at average 11days post-AMI. After measurement of coronary blood flow pattern, myocardial perfusion status was evaluated by myocardial contrast echocardiography(MCE. Perfusion status by MCE was analysed semiquantitatively and compared to various parameters of coronary flow and vasodilatory reserve of infarct-related artery. Results:After successful revascularization, perfusion defect by MCE was observed in 50%(n=7 of patients. The vasodilatory reserve was lower in patients with perfusion defect by MCE than those of patients without perfusion defect(p<0.05 and contol(p<0.05. There was no difference in coronary