Procena veličine infarkta miokarda analizom koronarnog protoka u bazalnim i u uslovima maksimalne hiperemije pomoću transtoraksne ehokardiografije

Abstract

Uvod: Analiza koronarnog protoka i parametara koji iz njega proističu u bazalnim i u uslovima maksimalne hiperemije pruža značajne podatke o stanju mikrocirkulacije u različitim patološkim stanjima. U našem radu je ispitivana povezanost između veličine infarkta miokarda u hroničnoj fazi nakon uspešne mehaničke reperfuzije i vrednosti koronarne rezerve protoka i dijastolnog deceleracionog vremena u bazalnim i u uslovima maksimalne hiperemije. Ciljevi: ove studije koja je uključila bolesnike sa prethodnim uspešno reperfundovanim prednjim infarktom miokarda u njegovoj hroničnoj fazi, su da se: 1. Utvrdi izvodljivost (feasibility) merenja koronarnog protoka, i koronarne rezerve protoka (CFR) neinvazivnom metodom transtoraksnom Doppler ehokardiografijom u infarktnoj i referentnoj koronarnoj arteriji 2. Utvrdi vrednost koronarne rezerve protoka u infarktnoj arteriji 3. Uporede vrednosti koronarne rezerve protoka u infarktnoj i referentnoj arteriji 4. Utvrdi veličina infarkta miokarda procenjena novom metodom na osnovu vrednosti koronarne rezerve protoka u infarktnoj i referentnoj arteriji i da se ovako izračunata veličina infarkta uporedi sa veličinom infarkta procenjenom na osnovu drugih metoda (enzimska, ehokardiografska, i scintigrafska) 5. Utvrdi dužina dijastolnog deceleracionog vremena (DDT) u infarktnoj i referentnoj arteriji kao i njihova povezanost sa veličinom infarkta miokarda 6. Utvrdi značaj procene dijastolnog deceleracionog vremena u infarktnoj i referentnj arteriji u hiperemiji Materijal i metode: Naša studija je obuhvatila 50 uzastopnih bolesnika sa prvim prednjim infarktom miokarda uspešno lečenih primarnom perkutanom koronarnom intervencijom...

Introduction: The analysis of coronary flow and its derived parameters provide useful information on state of microcirculation in different pathologocal settings. We assessed the relation between infarct size in chronic phase after successful mechanical reperfusion and coronary flow reserve and duration of diastolic deceleration time. The aims: of present study which included patients with previously successfully reperfused myocardial infarction in its chronic phase were: 1. To assess feasibility of coronary flow and coronary flow reserve (CFR) measurements in infarct related and reference artery using transthoracic Doppler echocardiography 2. To explore values of coronary flow reserve in infarct related coronary artery 3. To compare values of coronary flow reserve in infarct related and reference coronary artery 4. To estimate infarct size using novel pathophysiologically relevant model of infarct size estimation based on the measurement of coronary flow reserve in infarct related and reference coronary artery and assess its relation with other measurements of infarct size (enzymatic, echocardiographic and SPECT-MPI) . 5. To assess duration of diastolic deceleration time (DDT) of coronary flow in infarct related and in reference coronary artery in basal conditions and to assess their relation with infact size 6. To assess the value of DDT determination during hyperemia Methods: Our study included 50 consecutive patients with first anterior myocardial infarction successfully treated with primary percutaneous coronary intervention...