Invasive monitoring of coronary blood flow in acute myocardial infarction: pathogenetic and therapeutic relevance (original) (raw)

Atherosclerosis and Cardiovascular Disease, 1990

Abstract

The need to develop a reliable marker of reperfusion is important in view of the large number of pts in whom thrombolysis is now likely to be used. We measured coronary blood flow (CBF; thermodilution technique) in 12 pts presenting with acute myocardial infarction (AMI) and ST elevation in the anterior leads. After application of i.v. thrombolytic therapy (urokinase, 2 mil IU), CBF was measured every 30 min for 4 hrs and then every 4 hrs for 20 hrs. Coronary blood flow increased by more than 30% in 9 pts (G1): from 86±24 to 126±46 ml/min; p < 0.001. No significant changes were seen in the remaining 3 pts (G2). Coronary angiography was performed in all pts and showed patency of the infarct-related artery in 8/9 G1 pts (89%) and occlusion in the remaining four pts. We conclude that measurement of CBF is a relatively simple technique that appears both sensitive and specific in detecting coronary reperfusion in anterior AMI.

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