Pressure-derived fractional collateral blood flow: A primary determinant of left ventricular recovery after reperfused acute myocardial infarction

Cheol Whan Lee, Seong Wook Park, Goo Yeong Cho, Myeongki Hong, Jae Joong Kim, Duk Hyun Kang, Jae Kwan Song, Hyo Jung Lee, Seung Jung Park

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES. We evaluated the relation between pressure-derived fractional collateral flow (PDCF) and left ventricular (LV) recovery after reperfused acute myocardial infarction (AMI). BACKGROUND. The functional significance of collateral flow remains uncertain in AMI. METHODS. The PDCF was measured in 70 patients with first AMI (pain onset <12 h) treated with primary angioplasty (PA), being determined by simultaneous measurement of mean aorta pressure (Pa), distal coronary pressure during the balloon occlusion (Poc), and central venous pressure (CVP): (Poc-CVP)/(Pa-CVP)*100. Sufficient collateral (group I) was defined as PDCF index >24% and insufficient collateral (group II) as PDCF index <24%. Echocardiography was performed before, and on day 3, day 7, and day 30 after PA. Wall-motion recovery index (RI) was obtained by dividing the number of improved wall-motion segments (>grade 1) at follow-up by the number of abnormal wall-motion segments within the infarct zone at baseline. RESULTS. Baseline characteristics were similar between both groups. Peak levels of creatine kinase were lower in group I than group II (2,600 ± 1,900 U/liter vs. 4,100 ± 3,000, p < 0.05). At one month, infarct zone wall-motion score index (1.65 ± 0.54 vs. 2.31 ± 0.46, p < 0.01) and LV volume indexes were smaller in group I than in group II, whereas, LV ejection fraction was higher in group I than in group II (52.8 ± 8.3 vs. 45.9 ± 9.0, p < 0.01). The PDCF index was the strongest predictor of RI at one month (r = 0.61, p < 0.01). Time to reperfusion was not related to RI at one month. However, it was significantly related to RI in group II (r = -0.34, p < 0.05). CONCLUSIONS. The LV recovery after reperfused AMI is primarily determined by PDCF and is less dependent on time to reperfusion in patients with sufficient collaterals.

Original languageEnglish
Pages (from-to)949-955
Number of pages7
JournalJournal of the American College of Cardiology
Volume35
Issue number4
DOIs
Publication statusPublished - 2000 Mar 15

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Myocardial Infarction
Pressure
Reperfusion
Creatine Kinase
Stroke Volume
Pain

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Whan Lee, Cheol ; Park, Seong Wook ; Cho, Goo Yeong ; Hong, Myeongki ; Kim, Jae Joong ; Kang, Duk Hyun ; Song, Jae Kwan ; Lee, Hyo Jung ; Park, Seung Jung. / Pressure-derived fractional collateral blood flow : A primary determinant of left ventricular recovery after reperfused acute myocardial infarction. In: Journal of the American College of Cardiology. 2000 ; Vol. 35, No. 4. pp. 949-955.
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title = "Pressure-derived fractional collateral blood flow: A primary determinant of left ventricular recovery after reperfused acute myocardial infarction",
abstract = "OBJECTIVES. We evaluated the relation between pressure-derived fractional collateral flow (PDCF) and left ventricular (LV) recovery after reperfused acute myocardial infarction (AMI). BACKGROUND. The functional significance of collateral flow remains uncertain in AMI. METHODS. The PDCF was measured in 70 patients with first AMI (pain onset <12 h) treated with primary angioplasty (PA), being determined by simultaneous measurement of mean aorta pressure (Pa), distal coronary pressure during the balloon occlusion (Poc), and central venous pressure (CVP): (Poc-CVP)/(Pa-CVP)*100. Sufficient collateral (group I) was defined as PDCF index >24{\%} and insufficient collateral (group II) as PDCF index <24{\%}. Echocardiography was performed before, and on day 3, day 7, and day 30 after PA. Wall-motion recovery index (RI) was obtained by dividing the number of improved wall-motion segments (>grade 1) at follow-up by the number of abnormal wall-motion segments within the infarct zone at baseline. RESULTS. Baseline characteristics were similar between both groups. Peak levels of creatine kinase were lower in group I than group II (2,600 ± 1,900 U/liter vs. 4,100 ± 3,000, p < 0.05). At one month, infarct zone wall-motion score index (1.65 ± 0.54 vs. 2.31 ± 0.46, p < 0.01) and LV volume indexes were smaller in group I than in group II, whereas, LV ejection fraction was higher in group I than in group II (52.8 ± 8.3 vs. 45.9 ± 9.0, p < 0.01). The PDCF index was the strongest predictor of RI at one month (r = 0.61, p < 0.01). Time to reperfusion was not related to RI at one month. However, it was significantly related to RI in group II (r = -0.34, p < 0.05). CONCLUSIONS. The LV recovery after reperfused AMI is primarily determined by PDCF and is less dependent on time to reperfusion in patients with sufficient collaterals.",
author = "{Whan Lee}, Cheol and Park, {Seong Wook} and Cho, {Goo Yeong} and Myeongki Hong and Kim, {Jae Joong} and Kang, {Duk Hyun} and Song, {Jae Kwan} and Lee, {Hyo Jung} and Park, {Seung Jung}",
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Pressure-derived fractional collateral blood flow : A primary determinant of left ventricular recovery after reperfused acute myocardial infarction. / Whan Lee, Cheol; Park, Seong Wook; Cho, Goo Yeong; Hong, Myeongki; Kim, Jae Joong; Kang, Duk Hyun; Song, Jae Kwan; Lee, Hyo Jung; Park, Seung Jung.

In: Journal of the American College of Cardiology, Vol. 35, No. 4, 15.03.2000, p. 949-955.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pressure-derived fractional collateral blood flow

T2 - A primary determinant of left ventricular recovery after reperfused acute myocardial infarction

AU - Whan Lee, Cheol

AU - Park, Seong Wook

AU - Cho, Goo Yeong

AU - Hong, Myeongki

AU - Kim, Jae Joong

AU - Kang, Duk Hyun

AU - Song, Jae Kwan

AU - Lee, Hyo Jung

AU - Park, Seung Jung

PY - 2000/3/15

Y1 - 2000/3/15

N2 - OBJECTIVES. We evaluated the relation between pressure-derived fractional collateral flow (PDCF) and left ventricular (LV) recovery after reperfused acute myocardial infarction (AMI). BACKGROUND. The functional significance of collateral flow remains uncertain in AMI. METHODS. The PDCF was measured in 70 patients with first AMI (pain onset <12 h) treated with primary angioplasty (PA), being determined by simultaneous measurement of mean aorta pressure (Pa), distal coronary pressure during the balloon occlusion (Poc), and central venous pressure (CVP): (Poc-CVP)/(Pa-CVP)*100. Sufficient collateral (group I) was defined as PDCF index >24% and insufficient collateral (group II) as PDCF index <24%. Echocardiography was performed before, and on day 3, day 7, and day 30 after PA. Wall-motion recovery index (RI) was obtained by dividing the number of improved wall-motion segments (>grade 1) at follow-up by the number of abnormal wall-motion segments within the infarct zone at baseline. RESULTS. Baseline characteristics were similar between both groups. Peak levels of creatine kinase were lower in group I than group II (2,600 ± 1,900 U/liter vs. 4,100 ± 3,000, p < 0.05). At one month, infarct zone wall-motion score index (1.65 ± 0.54 vs. 2.31 ± 0.46, p < 0.01) and LV volume indexes were smaller in group I than in group II, whereas, LV ejection fraction was higher in group I than in group II (52.8 ± 8.3 vs. 45.9 ± 9.0, p < 0.01). The PDCF index was the strongest predictor of RI at one month (r = 0.61, p < 0.01). Time to reperfusion was not related to RI at one month. However, it was significantly related to RI in group II (r = -0.34, p < 0.05). CONCLUSIONS. The LV recovery after reperfused AMI is primarily determined by PDCF and is less dependent on time to reperfusion in patients with sufficient collaterals.

AB - OBJECTIVES. We evaluated the relation between pressure-derived fractional collateral flow (PDCF) and left ventricular (LV) recovery after reperfused acute myocardial infarction (AMI). BACKGROUND. The functional significance of collateral flow remains uncertain in AMI. METHODS. The PDCF was measured in 70 patients with first AMI (pain onset <12 h) treated with primary angioplasty (PA), being determined by simultaneous measurement of mean aorta pressure (Pa), distal coronary pressure during the balloon occlusion (Poc), and central venous pressure (CVP): (Poc-CVP)/(Pa-CVP)*100. Sufficient collateral (group I) was defined as PDCF index >24% and insufficient collateral (group II) as PDCF index <24%. Echocardiography was performed before, and on day 3, day 7, and day 30 after PA. Wall-motion recovery index (RI) was obtained by dividing the number of improved wall-motion segments (>grade 1) at follow-up by the number of abnormal wall-motion segments within the infarct zone at baseline. RESULTS. Baseline characteristics were similar between both groups. Peak levels of creatine kinase were lower in group I than group II (2,600 ± 1,900 U/liter vs. 4,100 ± 3,000, p < 0.05). At one month, infarct zone wall-motion score index (1.65 ± 0.54 vs. 2.31 ± 0.46, p < 0.01) and LV volume indexes were smaller in group I than in group II, whereas, LV ejection fraction was higher in group I than in group II (52.8 ± 8.3 vs. 45.9 ± 9.0, p < 0.01). The PDCF index was the strongest predictor of RI at one month (r = 0.61, p < 0.01). Time to reperfusion was not related to RI at one month. However, it was significantly related to RI in group II (r = -0.34, p < 0.05). CONCLUSIONS. The LV recovery after reperfused AMI is primarily determined by PDCF and is less dependent on time to reperfusion in patients with sufficient collaterals.

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