Functional significance of collateral blood flow in patients with recent acute myocardial infarction. A study using myocardial contrast echocardiography.

• DOI: 10.1161/01.cir.85.6.2080
• Publication Date: 2012-06-12T00:01:09Z
• Authors: P J Sabia; E R Powers; A R Jayaweera; M Ragosta; S Kaul
• Keywords: Circumflex; Collateral circulation

BACKGROUND We hypothesized that myocardial contrast echocardiography (MCE) can be used to both measure collateral blood flow as well assess the functional significance of collaterals in patients with acute infarction (AMI). METHODS AND RESULTS MCE was performed 33 recent AMI (12 +/- 7 days) and an occluded infarct-related artery (IRA), before after attempted percutaneous transluminal coronary angioplasty (PTCA). The size bed defined successful PTCA by injecting directly into opened IRA expressed a percent myocardium short-axis view. perfusion supplied determined. Transit rates microbubbles within collateralized regions were also measured transit normal adjacent beds. Regional function assessed using graded 1 (normal) 5 (dyskinetic). Collaterals on angiography 0 (none) 3 (abundant). larger for left anterior descending (LAD) than right (RCA) circumflex (LCx) arteries (37 6% versus 27 12% myocardium, p = 0.02). greater RCA LCx compared LAD (87 30% 72 22%, less 0.01). There poor correlation between MCE-defined angiographic grade (r 0.13). Regions likely show confluent hypoperfused zones reperfusion those not collaterals. Similarly, perfused either anterograde or correlated 0.67, 0.01) peak creatine kinase levels more associated Q waves. Finally, although there regional 0.20), significant negative spatial extent -0.57, CONCLUSION these patients. This technique may ideally suited assessment undergoing cardiac catheterization.