Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing direct percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Balloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.</p><p><b>METHODS</b>There were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine , β-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed.</p><p><b>RESULTS</b>The results showed that CK-MB, HAMD, SAS were significantly different (P < 0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7 ± 7.6) U/L vs. (76.7 ± 11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P < 0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%, P < 0.05).</p><p><b>CONCLUSION</b>In stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.</p>

The value of quantitative analysis of myocardial contrast echocardiography in diagnosing coronary atherosclerotic heart disease / 生物医学工程学杂志

This study was aimed to evaluate the quantitative analysis of MCE in diagnosing coronary atherosclerotic heart disease. MCE was performed on 10 patients with coronary artery disease. The parameters were extracted from imaging during the refilling period by time-intensity curve. SIpeak represents the peak of the signal intensity at the end of the perfusion process. Rt denotes refilling time, b indicates refilling rate. SI x b represents myocardial blood flow. SIpeak, Rt, b and SI x b showed significant differences in various segment of one patient. SIpeak exhibited significant difference between the control and observation groups (P < 0.05). The area under curve (AUC) of ROC was determined to be 0.782 and the optimum critical point was 64.4. SIpeak < or = 64.4 could predict the risk of coronary atherosclerotic heart disease with a sensitivity of 83.3% and a specificity of 69.0%. With the use of CnTI, myocardial perfusion was satisfactorily shown. The data from this initial study indicate that MCE and Qontrasts quantitative analysis software can evaluate the defect and damage area of myocardial infarction and low blood flow. SIpeak is a valuable predictor of coronary atherosclerotic heart disease.