| With the development of intervention, reperfusion is consideredas the best method to cure acute myocardial infarction (AMI).However, microvascular damage impaired the benefits of coronaryintervention. Clinical researches demonstrated that 1/6 to 1/3 ofpatients with vessel recanalization had microvascular damage, and apart of them had no-reflow phenomenon which showed coronaryblood lower than the third level of thrombolysis in myocardialinfarction (TIMI). Myocardial contrast echocardiography (MCE) canshow the coronary microcirculation directly by observing myocardialperfusion, so it is more objective than TIMI. However, just a fewclinical trials related to myocardial microcirculation afterpercutaneous coronary intervention (PCI) in patients whose coronaryblood showed TIMI Ⅲ by MCE were reported at present in ourcountry particularly with the new generation medicine SonoVue. Objective: The aim of this study was to observe myocardialmicrocirculation after percutaneous coronary intervention (PCI) inpatients whose coronary blood showed TIMI Ⅲ. Methods: 30 patients with AMI underwent two-dimensionalechocardiography and intravenous MCE after PCI.Results:Of 210 segments related to reperfusion in 30 patients,myocardial contrast score (MCS) was graded as 1 (146 segments,69.52%), 0.5 (53 segments) and 0 (11 segments, 30.48%). Nopatients' contrast score index (CSI) was less than 0.5.Of 137 segments related to reperfusion in 19patients (in threemonths), MCS was graded as 1 (103 segments, 75.18%), 0.5 and 0(34 segments, 24.82%). Of 73 segments related to reperfusion in11patients (after three months), MCS was graded as 1 (43 segments,58.90%), 0.5 and 0 (30 segments, 41.10%). The incidence of MCS 1was higher in patients (in three months) than others (P<0.05).Of 160 segments related to reperfusion of anterior descendingbranch, MCS was graded as 1 (110 segments, 68.75%), 0.5 and 0 (50segments, 31.25%). Of 50 segments related to reperfusion of rightcoronary artery, MCS was graded as 1 (36 segments, 72.00%), 0.5and 0 (14 segments, 28.00%). The incidence of MCS 1 between twogroups had no obvious difference(P>0.05).Of 115 segments related to reperfusion in 17 patients who hadone damaged coronary artery, MCS was graded as 1 (85 segments,73.91%), 0.5 and 0 (26.09%). Of 95 segments related to reperfusionin 13 patients who had two damaged coronary arteries, MCS wasgraded as 1 (61 segments, 64.21%), 0.5 and 0 (34 segments, 35.79%).The incidence of MCS 1 between two groups had no obviousdifference(P>0.05).Of 210 segments related to reperfusion in 30 patients, 51segments showed wall motion abnormalities. In these abnormalsegments, MCS was graded as 1 (19 segments, 37.25%), 0.5 (24segments) and 0 (8 segments, 62.75%). In the other normal segments,MCS was graded as 1 (127segments, 79.87%), 0.5 (29 segments) and0 (3 segments, 20.13%). The incidence of MCS 1 was higher innormal segments than others (P<0.05).30 patients were divided into Group A (CSI>0.8) and Group B(CSI≤0.8). The EF of Group A is higher than the one of Group B.(62.19±11.11 vs 45.50±10.76, P<0.05).All cases had satisfying imagings. Just one patient had allergicshock. No serious adverse events occurred in others throughout thestudy. Total adverse events was 10%. There was no influence to theelectrocardiogram.Conclusion:The vessel recanalization is not equal to effective myocardialperfusion. The third level of thrombolysis in myocardial infarction(TIMI) is not golden standard of successful reperfusion. In recentand distant period after PCI, dissatisfactory myocardial perfusion is acommon phenomenon. The condition of myocardial microcirculationis associated with myocardial constriction. The EF of patients withgood perfusion is higher than the one of others. Intravenous MCEwith SonoVue is a safe and no traumatic method to observemyocardial microcirculation.
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