Recovery of myocardial perfusion in acute myocardial infarction after successful balloon angioplasty and stent placement in the infarct-related coronary artery.
Recovery of myocardial perfusion in acute myocardial infarction after successful balloon angioplasty and stent placement in the infarct-related coronary artery.
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在梗塞相关冠状动脉成功进行球囊血管成形术和支架置入后，急性心肌梗塞的心肌灌注恢复。
DOI：
10.1016/s0735-1097(97)00300-8
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发表时间：
1997
影响因子：
24
通讯作者：
A. Schömig
中科院分区：
文献类型：
--
作者：
Franz‐Josef Neumann;I. Kósa;Timm L. Dickfeld;R. Blasini;M. Gawaz;J. Hausleiter;M. Schwaiger;A. Schömig
目标.本研究旨在探讨急性心肌梗死（MI）患者直接经皮冠状动脉腔内成形术（PTCA）后心肌灌注的变化。在最初成功再通梗死相关动脉后，冠状动脉灌注可能由于再闭塞、在扩张斑块处形成的血小板聚集体的远端栓塞或微血管再灌注损伤而恶化。这种变化可能会抵消早期干预的好处。该研究纳入了19例患者，在疼痛发作后24小时内通过经皮冠状动脉成形术（PTCA）和Palmaz-Schatz支架置入术成功再通了梗死相关动脉。通过多普勒血流速度测量和定量冠状动脉造影评估基础和罂粟碱诱导的冠状动脉血流。此外，用13-氮氨正电子发射断层扫描（PET）测量基础和腺苷诱导的心肌血流量。介入治疗完成后，再通血管的平均冠状动脉血流储备（CR）为1.56 ± 0.51;再灌注后1小时增加至2.04 ± 0.65（p = 0.013），2周增加至2.66 ± 0.72（p = 0.008，n = 16）。12例患者的PET研究显示，再通后第2天和2周之间，梗死区域的灌注缺损大小和CR（2.19 ± 0.89 vs. 2.33 ± 0.86）没有显著变化。然而，我们发现梗死区基础血流量（增加26%）和腺苷诱导血流量（增加40%）显著增加（p < 0.03）。尽管在急性MI中成功再通闭塞动脉后持续存在灌注缺陷，但大多数患者的梗死区域CR在1小时内改善，并在2周内进一步改善。
Objectives. This study sought to investigate changes in myocardial perfusion after direct percutaneous transluminal coronary angioplasty (PTCA) in acute myocardial infarction (MI).Background. After initially successful recanalization of the infarct-related artery, coronary perfusion may deteriorate as a result of reocclusion, distal embolization of platelet aggregates formed at the dilated plaque or microvascular reperfusion injury. This change could offset the benefit from early intervention.Methods. The study included 19 patients in whom the infarct-related artery was successfully recanalized by PTCA with Palmaz-Schatz stent placement within 24 h after the onset of pain. Basal and papaverine-induced coronary blood flow were assessed by Doppler flow velocity measurements and quantitative coronary angiography. In addition, basal and adenosine-induced myocardial blood flow were measured by nitrogen-13 ammonia positron emission tomography (PET).Results. Immediately after completion of the intervention, the average coronary flow reserve (CR) in the recanalized vessel was 1.56 ± 0.51; it increased to 2.04 ± 0.65 at 1 h (p = 0.013) and to 2.66 ± 0.72 at 2 weeks after reperfusion (p = 0.008, n = 16). PET studies in 12 patients revealed that perfusion defect size and CR in the infarct region (2.19 ± 0.89 vs. 2.33 ± 0.86) did not change significantly between day 2 after recanalization and 2 weeks. However, we found significant (p < 0.03) increases in basal (by 26%) and adenosine-induced (by 40%) blood flow in the infarct region.Conclusions. Despite the persistence of a perfusion defect after successful recanalization of the occluded artery in acute MI, CR of the infarct region improves in most patients within 1 h and further improves within 2 weeks.
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影响因子：
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作者：
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DOI：
10.1146/annurev.pa.26.040186.001221
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影响因子：
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影响因子：
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DOI：
--
发表时间：
1993
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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Muzik,O;Beanlands,R;Wolfe,E;Hutchins,GD;Schwaiger,M
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