Comparison of the improvement in myocardial perfusion and function in cases of rapid and slow electrocardiographic stage dynamics between patients with TIMI-3 flow after primary angioplasty for acute myocardial infarction

Medicina (Kaunas). 2015;51(4):217-21. doi: 10.1016/j.medici.2015.04.003. Epub 2015 Aug 5.

Abstract

Background and objective: Post-PCI TIMI flow grade 3 in infarct-related artery not always is associated with follow-up improvement in myocardial perfusion and function. We compared the improvement in myocardial perfusion and function in cases of rapid and slow electrocardiographic (ECG) stage dynamics between patients with TIMI-3 flow after primary angioplasty for acute myocardial infarction (MI).

Materials and methods: Ten patients with post-PCI TIMI-3 flow were divided into group A (n=50, no rapid change of ECG stages) and group B (n=50, with a ≥2 ECG stages per 2 days change rate).

Results: There were no significant changes after 3 months in scintigraphic (ejection fraction 44.6±9.3% vs. 42.0±3.4%, P=0.4; perfusion deficit severity 3.0±0.7 vs. 2.3±0.8, P=0.1) and echocardiographic (dysfunction score 1.9±0.2 vs. 1.6±0.5, P=0.2) data in group A. Scintigraphic data improved (ejection fraction 34.6±3.9% vs. 52.0±7.3, P=0.03; perfusion deficit severity 2.8±0.6 vs. 1.5±0.8, P=0.03) and changes in echocardiographic data were of borderline significance (dysfunction score 1.8±0.2 vs. 1.4±0.4, P=0.06) in group B.

Conclusions: There was not any change in myocardial perfusion and function in a case of slow change of ECG stages after reached post-PCI TIMI flow grade 3, while myocardial perfusion improved and function tended to improve in a case of the rate at least two ECG stages in 2 days after primary angioplasty for acute MI.

Keywords: Echocardiography; Electrocardiogram; Myocardial infarction; Percutaneous coronary intervention; Tc-99m-sestamibi scintigraphy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty*
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / surgery*
  • Myocardial Perfusion Imaging
  • Myocardial Reperfusion*
  • Percutaneous Coronary Intervention*
  • Prospective Studies
  • Stroke Volume
  • Technetium Tc 99m Sestamibi

Substances

  • Technetium Tc 99m Sestamibi