[Abnormal myocardial perfusion after infarction in patients with persistent TIMI grade-3 flow. Only an acute phenomenon?].

INTRODUCTION AND OBJECTIVES It has been suggested that abnormal perfusion as derived from cardiovascular magnetic resonance imaging (CMR) is a transient dysfunction of microcirculation after myocardial infarction (MI) with TIMI 3 flow. We hypothesized that defects of myocardial perfusion may persist during the following months. METHODS Forty-seven patients with MI and sustained TIMI 3 flow underwent intracoronary myocardial contrast echocardiography (MCE) 1 week and 6 months after infarction. Abnormal perfusion by MCE was regarded as > 1 hypoperfused segment. RESULTS At the first week, 20 patients showed abnormal perfusion as derived from MCE. At the sixth month 10 patients displayed chronic abnormal perfusion. These patients had greater left ventricular volumes and lower ejection fraction at the sixth month by CMR (P< .01). CONCLUSIONS MCE detects perfusion defects which can persist in chronic phase--this relates to more severe systolic dysfunction and increased left ventricular volumes.