J Korean Med Sci.  1998 Oct;13(5):466-472. 10.3346/jkms.1998.13.5.466.

Microvascular integrity as a predictor of left ventricular remodeling after acute anterior wall myocardial infarction

• Shim WJ
• Lee EM
• Hwang GS
• Ahn JC
• Song WH
• Lim DS
• Park CG
• Kim YH
• Seo HS
• Oh DJ
• Ro YM

• KMID: 645204
• DOI: http://doi.org/10.3346/jkms.1998.13.5.466

Abstract

The purpose of this study was to investigate the relation of microvascular integrity and ventricular remodeling after acute myocardial infarction. Twenty-six patients with first acute anterior myocardial infarction were studied before discharge with myocardial contrast echocardiography (MCE). Opacification index (OI) and wall motion index were calculated in the left anterior descending artery territory and left ventricular diastolic volume was measured at baseline and during a 9-month follow-up. In total 26 patients, the regional wall motion improved but the left ventricular volume and global function was not changed significantly at follow-up. When the patients were divided into 3 groups according to opacification index (> or = 0.75, 0.5 approximately 0.75, < or = 0.5) at baseline, functional recovery was not observed and significant left ventricular dilatation was developed in patients with < or = 0.5 OI. Among the baseline echo-parameters such as ejection fraction, wall motion score, left ventricular volume and opacification index, the best predictor for long term left ventricular dilatation was the opacification index by multivariate analysis. In patients with acute anterior wall infarction the assessment of microvascular integrity by MCE at acute stage provides useful information regarding recovery of dysfunctional regional wall motion and ventricular remodeling.

MeSH Terms

Coronary Vessels*
Female
Follow-Up Studies
Heart Ventricle/physiopathology
Human
Male
Middle Age
Myocardial Infarction/physiopathology*
Predictive Value of Tests
Ventricular Function, Left
Ventricular Remodeling*