－ S 231 －
― F-217 ―
The Relationship between Corrected Thrombolysis in Myocardial Infarction (TIMI) Frame Count Reserve and Intracoronary Doppler Parameters
아주대학교병원
*양형모, 윤명호, 정명일, 박진선, 임홍석, 최병주, 최소연, 강수진, 황교승, 신준한, 탁승제
Background: The corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) is simple continuous index of coronary flow and microvascular perfusion.
The studies for the relationship between frame count reserve (FCR) with coronary flow reserve (CFR) and microvascular function are limited. Objectives: The aim of this study is to evaluate the relation between FCR and CFR by intracoronary Doppler wire in patients with coronary artery disease. Methods: We studied 28 patients (mean age: 54 ± 12 years) including 10 acute myocardial infarction (AMI) patients. The CFR was measured by intracoronary Doppler wire and FCR was calculated as baseline CTFC/ hyperemic CTFC induced by intracoronary adenosine injection. The microvascular resistance index (MVRI) was calculated as mean distal coronary pressure divided by hyperemic averaged peak velocity (APV) assessed by Doppler wire. Results: Total 41 evaluations were performed (pre-PCI, 17; post-PCI, 24). The FCR is correlated with CFR (r= 0.747, p< 0.001), Baseline APV (r= -0.459, p= 0.003) and MVRI (r= 0.353, p= 0.044). Baseline CTFC is correlated with CFR (r= 0.603, p< 0.001) and baseline APV (r= -0.645, p< 0.001). Hyperemic CTFC is correlated with baseline APV (r= -0.333, p= 0.034), hyperemic APV (r= -0.519, p= 0.001) and MVRI (r= 0.560, p= 0.001). Although a small number of patients, the FCR is not correlated with intracoronary Doppler parameters in AMI patients. Conclusion: The frame count reserve is simple quantitative method and can estimate coronary flow velocity reserve. The microvascular function can be assessed by hyperemic corrected TIMI frame count and frame count reserve. Further study will be needed in AMI patients.
Frame count reserve Baseline CTFC Hyperemic CTFC
CFR r= 0.747 ** r= 0.603 ** r= -0.191
p= <0.001 p= <0.001 p= 0.232
Baseline APV r= -0.459 ** r= -0.645 ** r= -0.333 *
p= 0.003 p <0.001 p= 0.034
Hyperemic APV r= 0.225 r= -0.138 r= -0.519 **
p= 0.158 p= 0.391 p= 0.001
MVRI r= -0.353 * r= 0.066 r= 0.560 **
p= 0.044 p= 0.716 p= 0.001
**: p < 0.01, *: p < 0.05
― F-218 ―
A case of an anomalous hypertrophied muscle band in left ventricle
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
*Hyeon Min Ryu, Dong Heon Yang, Yong Seop Kwon, Myung Hwan Bae, Jang Hoon Lee, Hun Sik Park, Yongkeun Cho, Shung Chull Chae, Jae-Eun Jun, Wee-Hyun Park,
The hypertrophied muscle band (HMB) in left ventricle (LV) which can be misinterpreted as apical hypertrophic cardiomyopathy is a rare echocardiographic finding with normal LV wall thickness. Not only symptoms are produced, but also the electrocardiogram (ECG) changes are limited to the repolarization phase and show no progression by an even large HMB. Hence we report a case of 25 year-old woman who visited local medical clinic due to epigastric discomfort in January, 2007.The 24-hour Holter ECG showed multiple premature ventricular complexes regardless of unremarkable abdominal ultrasonogram. In echocardiogram, there was a HMB (3.23 x 10.8 cm), which ran toward interventricular septum (IVS) across LV and divided LV into apical and basal cavity, at apical one-third of LV. The blood flow was accelerated through spaces between HMB and IVS. The Doppler flow was dagger-shaped with high pressure gradient (30 mmHg). However, LV wall thickness was within normal range as well as apical contraction was good. In cardiac magnetic resonance imaging, there was a circumferential band-like myocardial hypertrophy at apex of LV. There was myocardial thinning and prominent trabeculae from proximal to distal HMB. However, there showed no hypokinesia in myocardial thinning site and no regional wall motion abnormality on cine image. There was focal fatty accumulation at base of HMB. Coronary angiogram showed no significant stenosis, LV gram showed septation in apical one-third of LV. She was discharged without any prescription.
