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首页> 外文期刊>Circulation journal >Novel acute collateral flow index in patients with total coronary artery occlusion during ST-elevation myocardial infarction
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Novel acute collateral flow index in patients with total coronary artery occlusion during ST-elevation myocardial infarction

机译：ST段抬高型心肌梗死患者全冠状动脉闭塞的新型急性侧支血流指数

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Background: The effect of collaterals to occluded coronary arteries during ST-elevation myocardial infarction (STEMI) is unclear. The conventional CVP-based formula to calculate collateral flow index during STEMI yields values higher than in elective patients, which prompted derivation of a modified formula, pertinent in STEMI when left ventricular mean diastolic pressure (LVMDP) is the extravascular pressure limiting collateral flow. We aimed to evaluate this new LVMDP-based acute collateral flow index (ACFI). Methods and Results: The pressure distal to coronary artery occlusion (Pd) was measured during intervention in 111 consecutive STEMI patients, 67 (61%) of whom underwent primary intervention, followed for 58 months. ACFI (0.18±0.17, median 0.15) correlated with both Pd and collateral grade (P<0.0001). Higher creatine kinase levels and white cell counts were measured in the lowest ACFI tertile compared with the highest tertile group (P<0.012). ACFI correlated slightly with early regional but not with global left ventricular ejection fraction or with long-term coronary events and mortality. Conclusions: The ACFI is appropriate for evaluating collateral function during STEMI. Collateral flow during STEMI may marginally limit myocardial damage but had no effect on left ventricular contraction or long-term mortality, most likely because of the low flow provided by emerging collaterals and the high proportion of patients undergoing intervention before the beneficial effect of collaterals could be realized.
机译：背景：在ST段抬高型心肌梗死（STEMI）期间，侧支对闭塞的冠状动脉的影响尚不清楚。传统的基于CVP的公式可计算STEMI期间的侧支血流指数，其值高于选择性患者，这促使推导了修正公式，与左室平均舒张压（LVMDP）是限制血管外压力的侧支血流的STEMI相关。我们旨在评估这种新的基于LVMDP的急性侧支血流指数（ACFI）。方法和结果：在111名连续的STEMI患者的干预过程中测量了远端冠状动脉闭塞（Pd）的压力，其中67名（61％）接受了初级干预，随访了58个月。 ACFI（0.18±0.17，中位数0.15）与Pd和抵押品等级相关（P <0.0001）。最低ACFI三分位数者与最高三分位数者相比，肌酸激酶水平和白细胞计数更高（P <0.012）。 ACFI与早期区域性轻微相关，但与整体左心室射血分数或长期冠状动脉事件和死亡率无关。结论：ACFI适用于评估STEMI期间的侧支功能。 STEMI期间的侧支血流可能在一定程度上限制了心肌损害，但对左心室收缩或长期死亡率没有影响，这很可能是由于新兴侧支血流提供的血流量低，以及在可能产生侧支血栓的有益效果之前接受干预的患者比例较高实现。

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