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European Journal of Echocardiography Advance Access originally published online on August 3, 2007
European Journal of Echocardiography 2008 9(3):363-367; doi:10.1016/j.euje.2007.06.001
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Transthoracic Doppler echocardiography assessment of left anterior descending artery flow in patients with previous anterior myocardial infarction

George Karatasakis1,*, Evaggelos Leontiadis1, Emmanuil Papadakis1, Nikolaos Koutsogiannis1, George Athanassopoulos1, Konstantinos Spargias1, Don Poldermans2, Stefanos E. Karagiannis1 and Dennis V. Cokkinos1

1 Department of Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, 17674, Athens, Greece
2 Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands

Received 3 February 2007; accepted after revision 2 June 2007; online publish-ahead-of-print 3 August 2007.

* Corresponding author. Tel: +30 210 9493165; fax: +30 210 9493912. E-mail address: georgekar2001{at}yahoo.com (G. Karatasakis).


  Abstract

Aim: We tested the hypothesis that shortening of diastolic pressure half time (PHT) of left anterior descending (LAD) coronary flow in patients with old reperfused anterior myocardial infarction (MI) is related to the presence of permanent myocardial damage of the reperfused area.

Methods and results: We studied 49 patients divided into: group A: 15 patients with previous anterior MI and evidence of myocardial scar; group B: 10 patients with previous anterior MI and no evidence of myocardial scar and group C: 24 patients without anterior MI. All patients underwent coronary angiography at least 6 months after an index event and any reperfusion procedure. Group A patients had lower PHT (199 ± 62 ms) than group C (377 ± 103 ms, p = 0.0001) and group B (316 ± 154 ms, p = 0.029) patients. No other LAD flow velocity parameter differed among the 3 groups. A PHT value of 265 ms discriminated patients with scarred anteriorwallwith a sensitivity of 79% and a specificity of 94% (0.88, p < 0.001).

Conclusion: Shortening of the LAD flow diastolic PHT in patients with remote, reperfused anterior MI reflects scarred myocardial tissue in the anteroapical wall while patients who maintain diastolic wall thickness after an acute coronary syndrome have PHT similar to patients without anterior MI.

Keywords: Transthoracic echocardiography; LAD flow


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