スギモト ケン   Ken Sugimoto
  杉本 研
   所属   川崎医科大学  医学部 臨床医学 総合老年医学
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Prediction of wall motion recovery from the left anterior descending coronary artery velocity pattern recorded by transthoracic doppler echocardiography in patients with anterior wall myocardial infarction retrospective and prospective studies.
掲載誌名 正式名:Japanese circulation journal
略  称:Jpn Circ J
ISSNコード:00471828/00471828
掲載区分国外
巻・号・頁 65(8),pp.717-722
著者・共著者 Shintani Y, Ito H, Iwakura K, Sugimoto K, Yamamoto K, Masuyama T, Kuzuya T, Hori M, Higashino Y, Fujii K
発行年月 2001/08
概要 The diastolic deceleration slope of coronary flow velocity is steeper in patients with substantial 'no reflow' phenomenon than in those without it. This study investigated whether functional outcomes in patients with anterior wall acute myocardial infarction (AMI) can be predicted by analyzing the coronary flow velocity pattern recorded with transthoracic Doppler (TTD) echocardiography. Coronary blood flow velocity in the distal left anterior descending coronary artery was recorded with TTD at day-2 after primary percutaneous transluminal coronary angioplasty/Stent in 51 patients with anterior AMI and the diastolic deceleration half time (DHT, ms) was measured. The wall motion score index (WMSI) was measured at day-1 and -21. In the retrospective study, the DHT was much shorter in those with a poor outcome than in those with good outcome (152 +/- 109 vs 395 +/- 128 ms, p<0.05). Receiver-operating characteristic analysis documented that DHT > or = 300 ms is a suitable cut-off point (sensitivity of 83% and specificity of 93%). In the prospective study (n=30), AWMSI(dl-d21) was significantly higher in those with a DHT > or = 300 ms than those without (0.3 > or = 0.5 vs 1.6 > or = 0.7, p<0.001). DHT correlated significantly with AWMSI(dl-d21) (r=0.76, p<0.001). Patients with a shorter DHT of diastolic coronary flow velocity have a poorer functional outcome among patients with anterior AMI. The TTD-determined DHT is a useful predictor of myocardial viability after an anterior AMI.
DOI 10.1253/jcj.65.717
PMID 11502048