Non invasive assessment of coronary flow and myocardial perfusion in patients with myocardial infarction before and after angioplasty

الملخص EN

-Background: Myocardial infarction is the most common cause of death in the developed world disease resulting from coronary occlusion by a thrombus which is initiated by plaque rupture.

This led to a great improvement of the treatment of MI using pharmacological and mechanical techniques, which resulted in the decrease in the incidence of morbidity and mortality.

Several methods have been used to assess this coronary reperfusion after MI, some of them are invasive as coronary angiogram which is considered the gold standard, the Doppler guide wire, other semi invasive methods as transoesohageal echocardiogram and non invasive methods as MRI .

Objectives: The aim of this study was to assess the role of transthoracic doppler echocardiogram using a high frequency transducer in assessment of coronary flow and myocarial perfusion before and after PCI.

Patients and methods: This study included 21 patients with anterior myocardial infarction planned for PCI.

All patients were evaluated by: History taking, clinical examination, resting electrocardiogram, transthoracic doppler echocardiogram to assess left anterior descending coronary artery flow and myocardial velocity gradient of the anterior wall before and after PCI, and coronary angiogram followed by percutaneous coronary intervention.

Conclusion: This study has shown that: - There was a significant correlation between LAD velocites measured by transthoracic echocardiogram and the TIMI flow grade and myocardial blush grade assessed by the coronary angiogram.

- The LAD flow pattern can predict a poor clinical outcome with a positive predictive value of 46.

2 % and a negative predictive value of 100 %.

- The Doppler Transthoracic Echocardiogram can assess both epicardial and microvascular reperfusion following PCI.