The Evaluation Of Myocardial Reperfusion After Revascularization In Coronary Artery Disease Patients

Background Large clinical trials have demonstrated percutaneous coronary intervention(PCI) plays an important role in releasing the symptoms and improving prognosis of coronary artery disease(CAD) patients. However, no reflow (NF) or low flow phenomenon appears in a lot of patients with thrombolysis in myocardial infarction (TIMI) grade 3 after revascularization. The patients with poor microvascular reperfusion have a significantly higher incidence of cardiac events. Consequently, myocardial reperfusion is also crucial to evaluate successful PCI therapy, other than angiographic TIMI grade 3. Clinical assessment methods of successful myocardial reperfusion include resolution of ST-segment elevation, myocardial enzyme, TIMI grade, corrected TIMI frame count (CTFC), myocardial blush grade (MBG), myocardial contrast echocardiography (MCE), Doppler pressure guide wire and myocardial nuclide imaging. MCE is a technique that uses microbubbles as a tracer during simultaneous ultrasound of the heart. The microbubbles can be used to provide quantitative information regarding the adequacy of myocardial blood flow, as well as the spatial extent of microvascular integrity. The aims of study were to evaluate myocardial reperfusion level after PCI using MCE and compare with other methods, explore the relationship of myocardial reperfusion level and improvement of left ventricular function, elucidate relative risk factors of impaired myocardial microcirculation after PCI.Methods The 62 patients with CAD of single artery stenosis and 6 patients excluding CAD (control) were studied. All patients had undergone selective coronary angiography and successful PCI in CAD patients. According to the results of coronary angiography , the patients were divided into 4 groups: A, normal artery (control group); B, artery stenosis 75%～95%; C, artery stenosis >95%; D, acute total occlusion. The contrast agent Sonovue was injected through left main and right coronary artery before and after 15 minutes PCI , then performed real-time intracoronary MCE along with safety...