RESUMO
During the past two years, key parts of poloidal and tangential x-ray imaging crystal spectrometers (PXCSs and TXCSs) have been upgraded. For poloidal XCSs, double-crystals of ArXVII and FeXXV were deployed. For fulfilling in situ alignment of a poloidal XCS, the beryllium window must be flexibly removed. By utilizing a design, where the beryllium window was installed in the vacuum chamber of the double-crystal, and between the double-crystal and wall of this chamber, an in situ alignment for the two spectrometers was fulfilled. Also, a new holder for the double-crystal was installed to allow for precise adjustments of azimuth angle and vertical height of the double-crystal. In order to facilitate these adjustments of double-crystal and installation of beryllium window, the chamber of the double-crystal for PXCS was upgraded from a cylinder to a cuboid. The distance between double-crystal and magnetic axis was extended from 8936 mm to 9850 mm in order to improve spatial resolution for PXCS, which is currently in the range from 1.237 mm to 4.80 mm at magnetic axis. Furthermore, a new pixelated detector (PILATUS 900K), which has a large sensitive area of 83.8 × 325.3 mm2 and which is vacuum compatible, is being implemented on the PXCS. This detector is mounted on a rail, so that its position can be changed by 50 mm to effectively record spectra of He-like argon and He-like iron (ArXVII and FeXXV). Similarly, a rail, which allows detector movement by 50 mm, was also installed in TXCS to alternatively record spectra of ArXVII and ArXVIII. Presently, the operation duration of PXCS and TXCS has been upgraded to hundreds of seconds in one shot. Ti- and uÏ-profiles measured by TXCS and charge exchange recombination spectroscopy (CXRS) were compared and found to be in good agreement.
RESUMO
BACKGROUND: Early restoration of coronary artery patency in acute myocardial infarction (AMI) has been linked to improvement in survival. However, early recanalization of an occluded epicardial coronary artery by either thrombolytic agents or percutaneous transluminal coronary angioplasty (PTCA) does not necessarily lead to left ventricular (LV) function recovery. HYPOTHESIS: The aim of this study was to evaluate the relation between persistent ST elevation shortly after primary stenting for acute myocardial infarction (AMI) and LV recovery. METHODS: Thirty-one patients with primary stenting for AMI were prospectively enrolled. To evaluate the extent of microvascular injury, serial ST-segment analysis on a 12-lead electrocardiogram recording just before and at the end of the coronary intervention was performed. Persistent ST-segment elevation (Persistent Group, n = 11) was defined as > or = 50% of peak ST elevation and resolution (Resolution Group, n = 20) was defined as < 50% of peak ST elevation. Echocardiography was performed on Day 1 and 3 months after primary stenting. RESULTS: At 3 months, infarct zone wall-motion score index (WMSI, 2.1 +/- 0.6 vs. 2.7 +/- 0.3, p < 0.05) was smaller in the Resolution Group than in the Persistent Group, whereas wall motion recovery index (RI, 0.4 +/- 0.3 vs. 0.1 +/- 0.2, p < 0.05) and ejection fraction (58 +/- 5 vs. 43 +/- 10%, p < 0.05) were larger in the Resolution Group than in the Persistent Group. The extent of persistent ST elevation (% ST) shortly after successful recanalization of the infarct-related artery was significantly related to RI at 3 months (r = -0.4, p < 0.05). However, time to reperfusion was not related to RI at 3 months. There was also significant correlation between corrected TIMI frame count and %ST (r = 0.4, p < 0.05). CONCLUSIONS: Persistent ST-segment elevation shortly after successful recanalization (> or = 50% of the peak value), as a marker of impaired microvascular reperfusion, predicts poor LV recovery 3 months after primary stenting for AMI.
