PurposeCoronary flow reserve (CFR) is recognized as an indicator of myocardial perfusion. The aim of this study was to assess the relationship between CFR in the non-infarcted myocardium and the incidence of major adverse cardiac events (MACEs).Materials and Methods100 consecutive patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) were enrolled in the present study, and divided into MACE and non-MACE groups according to the incidence of 12-month MACEs. Left ventricular function and CFR were analyzed using two-dimensional echocardiography and myocardial contrast echocardiography at one week after PCI. Cardiac troponin I levels were assayed to estimate peak concentrations thereof.ResultsThe MACE group was associated with lower CFR, compared to the non-MACE group (2.41 vs. 2.77, p<0.001). In the multivariable model, CFR in the non-infarcted myocardium was an independent predictor of 12-month MACE (hazard ratio: 0.093, 95% confidence interval: 0.020–0.426, p=0.002) after adjustment for baseline demographic and clinical characteristics.ConclusionCFR in the non-infarcted myocardium is a useful marker for predicting 12-month MACEs in patients with AMI undergoing primary PCI.

Objectives Coronary flow reserve in the non-infarcted myocardium has been reported to be impaired after the onset of myocardial infarction, however, the clinical significance of microvascular dysfunction in the non-infarcted myocardium has not fully examined. This study was designed to assess the relationship between coronary flow reserve in the remote region and left ventricular remodelling in the 6-month follow-up after acute myocardial infarction. Methods We studied 36 patients (mean age 58.8), with single-vessel AMI treated by successful revascularisation, and 10 normal subjects (mean age 53.4). We utilised two-dimensional echocardiography (2-DE) and real-time myocardial contrast echocardiography to assess left ventricular function and coronary flow reserve 1 week after percutaneous coronary intervention, respectively. And 6 months later 2-DE was repeated. Cardial Troponin I was routinely taken to estimate the peak concentration. Results 1 week after PCI, CFR was 2.05 in the infarcted region and 1.54 in the remote (p < 0.01). According to the value of CFR in the remote region, patients were divided into two groups. GroupI Patients with impaired CFR had higher peak cTnI level at admission than GroupII with preserved CFR (36.40:21.38, P < 0.05). Furthermore, in GroupI patients, left ventricular end diastolic volume was higher compared with that in GroupII patients. Conclusions Microvascular dysfunction in remote myocardium was common and had great significance in clinical. Higher value of CFR in the remote region was prognostic for lack of remodelling after AMI at follow-up.

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