Pulsatile flow: Difference between revisions
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{{SK}} Pulsatile blood flow pattern; pulsatile pattern; systolic flow reversal | |||
==Overview== | |||
A pulsatile flow pattern with retrograde or reversed flow during systole is associated with impaired [[myocardial perfusion]] and worse cardiovascular outcome which can be used for risk stratification on [[coronary angiography]]. | |||
==Definition== | |||
Pulsatile flow is defined as flow reversal with intermttent cessation of antegrade contrast-dye motion or frank reversal of contrast-dye motion during systole.<ref name="Gibson-2004">{{Cite journal | last1 = Gibson | first1 = CM. | last2 = Karha | first2 = J. | last3 = Murphy | first3 = SA. | last4 = de Lemos | first4 = JA. | last5 = Morrow | first5 = DA. | last6 = Giugliano | first6 = RP. | last7 = Roe | first7 = MT. | last8 = Harrington | first8 = RA. | last9 = Cannon | first9 = CP. | title = Association of a pulsatile blood flow pattern on coronary arteriography and short-term clinical outcomes in acute myocardial infarction. | journal = J Am Coll Cardiol | volume = 43 | issue = 7 | pages = 1170-6 | month = Apr | year = 2004 | doi = 10.1016/j.jacc.2003.11.035 | PMID = 15063425 }}</ref> It is coded as yes (present) or no (absent). | |||
==Clinical Significance== | |||
* Pulsatile flow pattern can be considered as a marker of heightened [[vascular resistance#Coronary vascular resistance|microvascular resistance]]. It may also be observed in other conditions such as [[ventricular hypertrophy]]. Patients with [[TIMI flow grade 2]] were shown to have a greater incidence of pulsatile flow compared to those with [[TIMI flow grade 3]].<ref name="Gibson-1999">{{Cite journal | last1 = Gibson | first1 = CM. | last2 = Murphy | first2 = S. | last3 = Menown | first3 = IB. | last4 = Sequeira | first4 = RF. | last5 = Greene | first5 = R. | last6 = Van de Werf | first6 = F. | last7 = Schweiger | first7 = MJ. | last8 = Ghali | first8 = M. | last9 = Frey | first9 = MJ. | title = Determinants of coronary blood flow after thrombolytic administration. TIMI Study Group. Thrombolysis in Myocardial Infarction. | journal = J Am Coll Cardiol | volume = 34 | issue = 5 | pages = 1403-12 | month = Nov | year = 1999 | doi = | PMID = 10551685 }}</ref> | |||
* The presence of pulsatile flow was associated with a fivefold increase in the risk of recurrent [[myocardial infarction]]. Patients with pulsatile flow had a higher risk of death at 30 days.<ref name="Gibson-2004">{{Cite journal | last1 = Gibson | first1 = CM. | last2 = Karha | first2 = J. | last3 = Murphy | first3 = SA. | last4 = de Lemos | first4 = JA. | last5 = Morrow | first5 = DA. | last6 = Giugliano | first6 = RP. | last7 = Roe | first7 = MT. | last8 = Harrington | first8 = RA. | last9 = Cannon | first9 = CP. | title = Association of a pulsatile blood flow pattern on coronary arteriography and short-term clinical outcomes in acute myocardial infarction. | journal = J Am Coll Cardiol | volume = 43 | issue = 7 | pages = 1170-6 | month = Apr | year = 2004 | doi = 10.1016/j.jacc.2003.11.035 | PMID = 15063425 }}</ref> | |||
* The presence of pulsatile pattern in the [[infarct related artery]] is reported to be associated with an increased incidence of pulsatile flow in nonculprit arteries and also with a slower nonculprit flow.<ref name="Gibson-1999">{{Cite journal | last1 = Gibson | first1 = CM. | last2 = Ryan | first2 = KA. | last3 = Murphy | first3 = SA. | last4 = Mesley | first4 = R. | last5 = Marble | first5 = SJ. | last6 = Giugliano | first6 = RP. | last7 = Cannon | first7 = CP. | last8 = Antman | first8 = EM. | last9 = Braunwald | first9 = E. | title = Impaired coronary blood flow in nonculprit arteries in the setting of acute myocardial infarction. The TIMI Study Group. Thrombolysis in myocardial infarction. | journal = J Am Coll Cardiol | volume = 34 | issue = 4 | pages = 974-82 | month = Oct | year = 1999 | doi = | PMID = 10520778 }}</ref> | |||
{{ | ==References== | ||
{{Reflist|2}} | |||
[[Category:Angiopedia]] | |||
[[Category:Cardiology]] | |||
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Revision as of 20:53, 11 November 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Synonyms and keywords: Pulsatile blood flow pattern; pulsatile pattern; systolic flow reversal
Overview
A pulsatile flow pattern with retrograde or reversed flow during systole is associated with impaired myocardial perfusion and worse cardiovascular outcome which can be used for risk stratification on coronary angiography.
Definition
Pulsatile flow is defined as flow reversal with intermttent cessation of antegrade contrast-dye motion or frank reversal of contrast-dye motion during systole.[1] It is coded as yes (present) or no (absent).
Clinical Significance
- Pulsatile flow pattern can be considered as a marker of heightened microvascular resistance. It may also be observed in other conditions such as ventricular hypertrophy. Patients with TIMI flow grade 2 were shown to have a greater incidence of pulsatile flow compared to those with TIMI flow grade 3.[2]
- The presence of pulsatile flow was associated with a fivefold increase in the risk of recurrent myocardial infarction. Patients with pulsatile flow had a higher risk of death at 30 days.[1]
- The presence of pulsatile pattern in the infarct related artery is reported to be associated with an increased incidence of pulsatile flow in nonculprit arteries and also with a slower nonculprit flow.[2]
References
- ↑ 1.0 1.1 Gibson, CM.; Karha, J.; Murphy, SA.; de Lemos, JA.; Morrow, DA.; Giugliano, RP.; Roe, MT.; Harrington, RA.; Cannon, CP. (2004). "Association of a pulsatile blood flow pattern on coronary arteriography and short-term clinical outcomes in acute myocardial infarction". J Am Coll Cardiol. 43 (7): 1170–6. doi:10.1016/j.jacc.2003.11.035. PMID 15063425. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Gibson, CM.; Murphy, S.; Menown, IB.; Sequeira, RF.; Greene, R.; Van de Werf, F.; Schweiger, MJ.; Ghali, M.; Frey, MJ. (1999). "Determinants of coronary blood flow after thrombolytic administration. TIMI Study Group. Thrombolysis in Myocardial Infarction". J Am Coll Cardiol. 34 (5): 1403–12. PMID 10551685. Unknown parameter
|month=ignored (help)