Li Chun-Mei, Zhang Xing-Hua, Ma Xiao-Jing, Zhu Xing-Lei
Department of Cardiology, Shandong Provincial Hospital of Shandong University, Jinan 250021, China.
Catheter Cardiovasc Interv. 2008 Feb 15;71(3):312-7. doi: 10.1002/ccd.21376.
To evaluate myocardial tissue perfusion by corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and ST-segment resolution after successful percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
Early and sustained potency of infarct-related artery (IRA) has become the main goal of reperfusion therapy in patients with AMI. However, myocardial tissue perfusion may remain impaired even after the achievement of TIMI grade 3 flow of the epicardial artery without residual stenosis.
CTFC was measured after successful PCI in 63 patients with first AMI. The extent of ST-segment resolution was recorded 1 hr after reperfusion therapy. The wall motion score index (WMSI) was assessed before and 1 month after PCI. Then we studied the correlation between CTFC, ST-segment resolution, and WMSI.
According to CTFC, the patients with TIMI grade 3 flow after PCI were divided into two groups: CTFC fast group and CTFC slow group. CTFC fast group had higher percentage of complete ST resolution (54.1% vs. 25.0%, P < 0.05) and lower percentage of no ST resolution (2.6% vs. 29.2%, P < 0.05). Improvement of WMSI in the CTFC fast group was significantly greater than that of the CTFC slow group (1.30 +/- 0.41 vs. 0.64 +/- 0.30, P < 0.05). CTFC had a significant negative correlation with the change in WMSI (r = -0.75, P < 0.01).
Combined with ST-segment resolution, CTFC could predict risk for patients with successful reperfusion therapy after AMI and provide evidence for additional adjunctive treatment.
通过校正的心肌梗死溶栓（TIMI）帧数（CTFC）及急性心肌梗死（AMI）患者成功接受经皮冠状动脉介入治疗（PCI）后的ST段回落情况，评估心肌组织灌注。
梗死相关动脉（IRA）早期及持续开通已成为AMI患者再灌注治疗的主要目标。然而，即使在无残余狭窄的情况下实现了心外膜动脉TIMI 3级血流，心肌组织灌注仍可能受损。
对63例首次发生AMI的患者成功进行PCI后测量CTFC。再灌注治疗1小时后记录ST段回落程度。在PCI术前及术后1个月评估室壁运动评分指数（WMSI）。然后研究CTFC、ST段回落及WMSI之间的相关性。
根据CTFC，将PCI术后TIMI 3级血流的患者分为两组：CTFC快速组和CTFC缓慢组。CTFC快速组完全ST段回落的百分比更高（54.1%对25.0%，P<0.05），无ST段回落的百分比更低（2.6%对29.2%，P<0.05）。CTFC快速组WMSI的改善明显大于CTFC缓慢组（1.30±0.41对0.64±0.30，P<0.05）。CTFC与WMSI的变化呈显著负相关（r=-0.75，P<0.01）。
结合ST段回落情况，CTFC可预测AMI患者成功再灌注治疗后的风险，并为额外的辅助治疗提供依据。
