| Objective: The purpose of this article is to elucidate the relative factors for angiographic no-reflow phenomenon, and the variation of left ventricular function and clinical implication of ST segment reduction after primary percutaneous coronary intervention(PCI) with ST segment elevation acute myocardial infarction(STEMI). Methods: Cilni- cal and angiographic data of 497 patients after primary PCI for STEMI were retrospectively analysed between January 1999 and October 2002. no-reflow phenomenon is defined as anter- grade flow ≤TIMI 2 class, and normal flow is defined as antergrade TIMI 3 class when infartion relative artery was completely opened without thrombosis, embolism, dissection, spasam, and competitive flow. 58 patients were with angiographic no-reflow phenomenon, 6 patients were exclude from no-reflow group bccause of shortness of clinical and angio- graphic data, 52 patients werw studied in angiographic no-reflow group. Men were 39 patients, women were 13 pa- tiens; Mean age was 60.5±11.4 yaears old. Angiographic no-reflow group included in the left anterior descendingartery in 25 pateints, and right coronary artery in 22 patients and left circumflex branch in 5 patients. Angiographic no-reflow group incuded anterior infarction in 25 pateints, and inferior infarc- tion in 27 pateints, and inferior infarction with posterior infarc- tion in 10 pateints, and inferior infarction with right ventricular infarctio in 8 pateints. Analysis left ventricular function of angiographic no-reflow was 47 patients because 11 patients were excluded with shortness of clinical and angiographic data. Men was 36 patients, women was 11 patients; Mean age 60.9±l1.7 years old. 60 patients with normal flow group rando- mized from 439 patients for STEMI with coronary antergrade flow TIMI 3 class after primary PCI with table of Excel random count were studied. Men was 48 patients, wonmen was 12 patients; Mean age 56.6±10.9 years old. Normal flow group included in the left anterior descending artery in 28 pateints, and right coronary artery in 25patients and left circumflex branch in 7 patients. Normal flow group incuded anterior in- farction in 28 pateints, and inferior infarction in 32 pateints, and inferior infarction with posterior infarction in 11 pateints-. and inferior infarction with right ventricular infarctio in 6 pateints. Multiple logistic regression analysis was used to identify independent relative factors of the no-reflow phenomenon. Results: Incidence of the no-reflow phenomenon is 12.6%. Univariate analysis showed that diabetes mellitus, symptom onset to reflow time, pre-infarction agina, Killip class, number of Q waves on electrocardiogam and wall motion score(WMS) are related to the no-reflow phenomenon (P<0.05). However, multiple logistic regression analysis indicated that the symptom onset to reflow time , the pre-infarction again , Killip class , the number of Q waves on electrocardiogam are the relative factors of the no-reflow phenomenon(P <0.05). WMS, left ventricular ejection function(LVEF), cardiac index (CI) , stroke volume index(SVI) improved in 2 weeks after procedure in normal flow group(P<0.05). WMS, LVEF, CI, SVI improved, and leftventricular end diastolic volumes (LVEDV) , left ventricular end systolic volumes(LVESV) decrease in the normal flow group complicated left ventricular dysfunction in 2 weeks after procedure(P<0.01). However, LVEDV , LVESV increased in patients with angiographic no-reflow phenomenon with complicated left ventricular dys- function in 2 weeks after procedure(P<0.01).ST segment elevation index was not significance in patients with angiographic no-reflow phenomenon before and after PCI (0.32 ± 0.14, 0.27±0.13mv) (P>0.05), it was significance in normal flow patients before and after PCI(0.35± 0.15, 0.17±0.08mv) (P<0.01). It rapid decreased in normal flow patients, comparison with patients for angiographic no-reflow(0.17 ± 0.08mv, 0.27 ± 0.13mv, P<0.01). The wall motion score(WMS) improved and left ventricular ejection fraction(LVEF) , cardiac index(CI) and stroke v...
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