Correlation Between Distal Left Anterior Descending Artery Flow Velocity by Transthoracic Doppler Echocardiography and Corrected TIMI Frame Count Before Mechanical Reperfusion in Patients With Anterior Acute Myocardial Infarction

Souki Lee; Yutaka Otsuji; Shinichi Minagoe; Shuichi Hamasaki; Koichi Toyonaga; Hachiro Obata; Takuro Takumi; Hiroshi Arimura; Masaaki Miyata; Sadatoshi Biro; Hitoshi Toda; Chuwa Tei

doi:10.1253/circj.69.1022

Clinical Investigation

Correlation Between Distal Left Anterior Descending Artery Flow Velocity by Transthoracic Doppler Echocardiography and Corrected TIMI Frame Count Before Mechanical Reperfusion in Patients With Anterior Acute Myocardial Infarction

Souki Lee, Yutaka Otsuji, Shinichi Minagoe, Shuichi Hamasaki, Koichi Toyonaga, Hachiro Obata, Takuro Takumi, Hiroshi Arimura, Masaaki Miyata, Sadatoshi Biro, Hitoshi Toda, Chuwa Tei

Author information

Souki Lee
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Yutaka Otsuji
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Shinichi Minagoe
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Shuichi Hamasaki
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Koichi Toyonaga
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Hachiro Obata
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Takuro Takumi
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Hiroshi Arimura
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Masaaki Miyata
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Sadatoshi Biro
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Hitoshi Toda
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
Chuwa Tei
Department of Cardiology, Kagoshima City Hospital and Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

Keywords: Acute myocardial infarction, Coronary reperfusion, Echocardiography

JOURNAL FREE ACCESS

2005 Volume 69 Issue 9 Pages 1022-1028

DOI https://doi.org/10.1253/circj.69.1022

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Abstract

Background This study was designed to determine the utility of transthoracic Doppler echocardiography (TTDE) in evaluating angiographic Thrombolysis in Myocardial Infarction (TIMI) frame count as a quantitative index of coronary reperfusion in patients with anterior acute myocardial infarction (AMI) before mechanical reperfusion. Methods and Results Color and pulsed TTDE was performed to evaluate distal left anterior descending coronary artery (LAD) reperfusion in 56 consecutive patients with a first anterior AMI before coronary intervention, and these findings were compared with the corrected TIMI frame count (cTFC) by subsequent angiography. Twenty-four of the 56 patients had LAD reperfusion (TIMI 2 or 3) by angiography. Visual antegrade distal LAD flow by color TTDE was detected in 21 of these 24 patients. In the 21 patients, diastolic peak velocity of the distal LAD flow by pulsed TTDE showed a significant correlation with cTFC by angiography (r=-0.74, p<0.001). The diagnosis of high risk with angiographic cTFC >40 by distal LAD peak velocity <21 cm/s using TTDE had a sensitivity, specificity, and accuracy of 82%, 93%, and 91%, respectively. Conclusion TTDE enables noninvasive and quantitative evaluation of distal LAD reperfusion in patients with anterior AMI in the acute phase before mechanical reperfusion. (Circ J 2005; 69: 1022 - 1028)

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