Role of pre-infarction angina and inflammatory status in the extent of microvascular obstruction detected by MRI in myocardial infarction patients treated by PCI.

Background/objectives: The extent of microvascular obstruction (MVO) during myocardial infarction referred to as the "no-reflow phenomenon", may determine myocardial damage. Our study aimed to investigate the incidence and the influencing factors of MVO in patients with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous intervention (PCI).

Patients, Methods: Using contrast-enhanced MRI, microvascular obstruction was defined as early hypoenhancement.

Myocardial flow reserve parametric map, assessed by first-pass MRI compartmental analysis at the chronic stage of infarction.

Regional myocardial flow and flow reserve (MFR) were assessed by compartmental analysis of Gd-enhanced MRI first-pass data in 7 patients with atypical chest pain, and in 15 patients with previous transmural myocardial infarction. The FE product (Flow x Extraction coefficient), derived from the modified Kety equation, was measured in regions corresponding to the Tetrofosmine-SPECT fixed defect and in remote normal regions. The FE product at rest and hyperemic FE product were similar in healed revascularized tissues (70.

[Cartography of absolute myocardial perfusion with magnetic resonance imaging. Methods and results].

Ultra-rapid dynamic MRI (one image per heart beat) can follow the progression of the intra-myocardial signal during the first passage of diffusable gadolinium chelates injected as a bolus through a peripheral vein. A quantitative evaluation of myocardial perfusion is possible using a compartmental model of analysis. Absolute myocardial flow can be measured at rest and during hyperaemia induced by dipyridamole.

[MRI semeiology of segmental contraction abnormalities in arrhythmogenic dysplasia of the right ventricle].

The diagnosis of localized arrhythmogenic right ventricular dysplasia may be difficult to ascertain. Aside from electrophysiological arguments, visualization of an abnormal right ventricular contraction pattern is of crucial importance for diagnosis. Cine-MR is almost the only examination method which offers detailed informations on the right ventricular contraction pattern.

Comparison between abnormalities in segmental endocardial motion and abnormalities in segmental wall thickening after anterior myocardial infarction. A cine-magnetic resonance study.

In this study, two patterns of regional contract on of the left ventricle have been studied: endocardial motion and wall thickening, in order to check which of these was the most affected after myocardial infarction. The clinical relevance of this comparison was to assess which parameter of the regional contraction abnormality would best depict the severity of the infarction. Long axis cine-magnetic resonance slices were used to assess segmental systolic left ventricular endocardial motion and segmental systolic wall thickening in 39 normal subjects and in 30 patients at the chronic stage of an anterior myocardial infarction.

Recanalization of occluded superficial femoral arteries using the rotational transluminal angioplasty catheter system (ROTACS).

A total of 85 occluded superficial femoral arteries were treated using the rotational transluminal angioplasty catheter system (ROTACS). The mean length of the occlusions was 7cm; 76% were uncalcified or only slightly calcified whereas 24% were calcified or highly calcified. The mean preoperative ankle:brachial index was 0.

[Rotacs: a device used in coronary and peripheral arterial recanalization].

The authors report their preliminary results with the Rotacs system in the reopening of chronic coronary artery occlusion by low-speed rotational angioplasty. This system improves the percentage of coronary recanalisation in cases where it is impossible to pass the guide wire alone. It seems to be an effective, low-cost complementary tool for the treatment of this type of lesion.

[Accentuation of myocardial ischemia during coronary recanalization in the acute phase of myocardial infarction].

Coronary recanalisation during the acute phase of myocardial infarction, especially by in situ infusion of thrombolytic agents, is accompanied in most cases by rapid regression of chest pain and a reduction in the degree of ST elevation. However, a multicentre retrospective study of 104 attempts at recanalisation, including 78 successful procedures, showed in 10 cases (12.8 p.

[Myocardial infarction due to acute right coronary thrombosis. Treatment with in situ fibrinolysis, absence of angiographic residual stenosis].

The case of a 44 year old patient with inaugural postero-diaphragmatic myocardial infarction is reported. Coronary angiography performed at the 3 rd hour showed total occlusion of the right coronary artery at the level of its second segment. A streptokinase perfusion through a Judkins' catheter positioned in the ostium of the right coronary artery using Rentrop's technique, resulted in recanalisation of the vessel at the 45 th minute.

[Hemodynamic effects of the association of nifedipine and acebutolol].

The aim of this study was to assess the effects of the association of sublingual nifedipine and intravenous acebutolol on left ventricular inotropism. A series of 30 randomised patients underwent hemodynamic investigation repeated after a 30 minute interval comprising measurement of left ventricular (LVP) and aortic (AoP) pressures and ventriculography (Vo). Between the two Vo, Group I (N = 10) were given 20 mg sublingual nifedipine (N), Group II (N = 0) were given I mg/Kg acebutolol (A) intravenously in 5 minutes, and Group III (N = 10) the association of 20 mg sublingual N and I mg/Kg intravenous A.