NIVELES DE PERFUSION TISULAR MIOCARDICA: SU VALORACION Y SU RELACION CON LOS RESULTADOS CLINICOS

(especial para SIIC © Derechos reservados)
Para mejorar los resultados luego de la terapia de revascularización miocárdica, no se debe sólo mejorar el flujo sino también obtener un buen nivel de perfusión tisular, el cual se relaciona inversamente con el tamaño del infarto y la mortalidad.
bigelow.jpg Autor:
Brian c. Bigelow
Columnista Experto de SIIC
Artículos publicados por Brian c. Bigelow
Coautores
Raphaelle Dumaine* Pedro Martinezclark** C. Michael Gibson*** 
M.D., Cardiovascular Division, Department of Medicine, Brigham & Women's*
M.D., Beth Israel Deaconess Medical Center, Harvard Medical School**
M.S., M.D., Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital***
Recepción del artículo
3 de Septiembre, 2003
Aprobación
26 de Febrero, 2004
Primera edición
3 de Marzo, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El objetivo del tratamiento de revascularización, tanto en los procedimientos electivos como en los de urgencia, es restablecer el flujo sanguíneo normal en las arterias epicárdicas. Con el aumento de la comprensión de la perfusión, se ha hecho cada vez más evidente que, además del flujo epicárdico, también hay que mejorar la perfusión miocárdica para lograr resultados clínicos superiores. Las nuevas técnicas han hecho posible evaluar la perfusión miocárdica a través del arteriograma coronario. En este artículo se revisan las técnicas angiográficas actuales para evaluar la perfusión miocárdica y la asociación de estos hallazgos con los resultados clínicos.

Palabras clave
Infarto miocárdico


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Abstract
The goal of revascularization therapy in both elective and urgent procedures has been to restore normal blood flow in the epicardial arteries. As the understanding of perfusion has improved, however, it has become increasingly apparent that in addition to epicardial flow, myocardial perfusion must also be restored to improve clinical outcomes. Newer techniques have now made it possible to assess myocardial perfusion on the coronary arteriogram. This article reviews current angiographic techniques to assess myocardial perfusion and the association of these findings with clinical outcomes.

Key words
Infarto miocárdico


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Clasificación en siicsalud
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Especialidades
Principal: Cardiología, Diagnóstico por Imágenes
Relacionadas: Medicina Interna



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Bibliografía del artículo
  1. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. TIMI Study Group. N Engl J Med, 1985. 312(14): p. 932-6.
  2. The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction. The GUSTO Angiographic Investigators. N Engl J Med, 1993. 329(22): p. 1615-22.
  3. Anderson, J.L., et al., TIMI perfusion grade 3 but not grade 2 results in improved outcome after thrombolysis for myocardial infarction. Ventriculographic, enzymatic, and electrocardiographic evidence from the TEAM-3 Study. Circulation, 1993. 87(6): p. 1829-39.
  4. Karagounis, L., et al., Does thrombolysis in myocardial infarction (TIMI) perfusion grade 2 represent a mostly patent artery or a mostly occluded artery Enzymatic and electrocardiographic evidence from the TEAM-2 study. Second Multicenter Thrombolysis Trial of Eminase in Acute Myocardial Infarction. J Am Coll Cardiol, 1992. 19(1): p. 1-10.
  5. Vogt, A., et al., Impact of early perfusion status of the infarct-related artery on short-term mortality after thrombolysis for acute myocardial infarction: retrospective analysis of four German multicenter studies. J Am Coll Cardiol, 1993. 21(6): p. 1391-5.
  6. Gibson, C.M., et al., TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation, 1996. 93(5): p. 879-88.
  7. Gibson, C.M., et al., Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs. Circulation, 2000. 101(2): p. 125-30.
  8. Gibson, C.M., et al., Methodologic and Clinical Validation of the TIMI Myocardial Perfusion Grade in Acute Myocardial Infarction. J Thromb Thrombolysis, 2002. 14(3): p. 233-7.
  9. van \'t Hof, A.W., et al., Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Zwolle Myocardial Infarction Study Group. Circulation, 1998. 97(23): p. 2302-6.
  10. Alexander, J.H., et al., Association between minor elevations of creatine kinase-MB level and mortality in patients with acute coronary syndromes without ST-segment elevation. PURSUIT Steering Committee. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy. Jama, 2000. 283(3): p. 347-53.
  11. Califf, R.M., et al., Myonecrosis after revascularization procedures. J Am Coll Cardiol, 1998. 31(2): p. 241-51.
  12. Gibson, C.M., et al., Relationship of creatine kinase-myocardial band release to Thrombolysis in Myocardial Infarction perfusion grade after intracoronary stent placement: an ESPRIT substudy. Am Heart J, 2002. 143(1): p. 106-10.
  13. Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial. Lancet, 2000. 356(9247): p. 2037-44.
  14. Baran, K.W., et al., Double-blind, randomized trial of an anti-CD18 antibody in conjunction with recombinant tissue plasminogen activator for acute myocardial infarction: limitation of myocardial infarction following thrombolysis in acute myocardial infarction (LIMIT AMI) study. Circulation, 2001. 104(23): p. 2778-83.
  15. Angeja, B.G., et al., TIMI myocardial perfusion grade and ST segment resolution: association with infarct size as assessed by single photon emission computed tomography imaging. Circulation, 2002. 105(3): p. 282-5.
  16. Wong, G.C., et al., Elevations in troponin T and I are associated with abnormal tissue level perfusion: a TACTICS-TIMI 18 substudy. Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis in Myocardial Infarction. Circulation, 2002. 106(2): p. 202-7.
  17. Cannon, C.P., et al., Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med, 2001. 344(25): p. 1879-87.
  18. Dibra, A., et al., Thrombolysis in myocardial infarction myocardial perfusion grade in angiography correlates with myocardial salvage in patients with acute myocardial infarction treated with stenting or thrombolysis. J Am Coll Cardiol, 2003. 41(6): p. 925-9.
  19. Schomig, A., et al., Coronary stenting plus platelet glycoprotein IIb/IIIa blockade compared with tissue plasminogen activator in acute myocardial infarction. Stent versus Thrombolysis for Occluded Coronary Arteries in Patients with Acute Myocardial Infarction Study Investigators. N Engl J Med, 2000. 343(6): p. 385-91.
  20. Kastrati, A., et al., Myocardial salvage after coronary stenting plus abciximab versus fibrinolysis plus abciximab in patients with acute myocardial infarction: a randomised trial. Lancet, 2002. 359(9310): p. 920-5.
  21. Haager, P.K., et al., Prediction of clinical outcome after mechanical revascularization in acute myocardial infarction by markers of myocardial reperfusion. J Am Coll Cardiol, 2003. 41(4): p. 532-8.
  22. Henriques, J.P., et al., Angiographic assessment of reperfusion in acute myocardial infarction by myocardial blush grade. Circulation, 2003. 107(16): p. 2115-9.
  23. Stone, G.W., et al., Impact of normalized myocardial perfusion after successful angioplasty in acute myocardial infarction. J Am Coll Cardiol, 2002. 39(4): p. 591-7.

Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

 English title
 Abstract
 Key words
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