P141	Evaluation of hemorheorogical profiles in patients with no-reperfusion phenomenon in acute ST elevation myocardial infarction treated by primary percutaneuous coronary intervention.
J.Wasilewski, B.Turczynski, V.Kowalik, T.Osadnik, L.Polonski
Silesian Center for Heart Disease, Zabrze, PL.

Background: Blood rheology is a well-known major determinant of microcirculatory blood flow. Alternation of read blood cell (RBC) aggregation, deformability and plasma viscosity are major contributors that cause an increase in vascular resistance. Hemorheological alternation are observed in acute myocardial infarction but their profiles were not evaluated in patients with no-myocardial reperfusion after recanalization of infarct related coronary artery. To address those question RBC aggregability, deformability, blood and plasma viscosity were studied in 23 patients with ST elevation acute myocardial infarction treated by primary coronary intervention and postrocedural TIMI flow 3 (Thrombolisis In Myocardial Infarction). Method: RBC aggregation and deformability were measured by LORCA (Laser-assisted Optrical Rotational Cell Analyzer) method. The blood and plasma viscosity were evaluated at share rate 150s-1 and 300s-1 respectively. Results: There were no significant differences in baseline characteristics between the two groups. Plsma viscosity, RBC adggregability were significantly increased in no-reperfusion group, compared to patients with myocardial reperfusion (myocardial perfusion grade 3). Index of RBC deformability revealed impaired RBC deformability in no-reperfusion group. Detailed results are shown is in the table.   No-reperfusion N=9 Reperfusion N=14 p Hematocrit [%] 38,7±4,3 42,15±4,0 NS Blood viscosity [mPas] 4,63±1,22 4,38±0,46 NS Plasma viscosity [mPas] 1,47±0,13 1,32±0,09 <0.01 Aggregation index [%] 67,42±8 59±9,5 <0,05 Aggregation half time [s] 1,86±0,9 2,94±1,6 <0,05 Deformability index [%] at shear stress 10,06 Pa 44,6±5,07 49,13 ±2,43 <0,05 Conclusion: Our results suggest that increased plasma viscosity, RBC hyperaggregation and impaired RBC deformability appear to contribute of worsening of microcirculatory blood flow and might be one important factor in the development of no-myocardial reperfusion phenomenon after successful restoration of epicardial coronary blood flow in patients with acute myocardial infarction.

Copyright © 2005 S. Karger AG, Basel. Any further use of this abstract requires written permission from the publisher.