[Influence of intracoronary administration of anisodamine on no-reflow, ventricular function and systolic synchrony in acute myocardial infarction patients undergoing percutaneous coronary intervention].

Objective To evaluate the influence of intracoronary administration of anisodamine on myocardial blush grade(MBG)and left ventricular regional and global systolic function and synchrony in the acute myocardial infarction(AMI)patients with no-reflow phenomenon post percutaneous coronary intervention(PCI).Methods Forty-seven AMI patients who underwent PCI within 12 hours of onset and MBG was 0-1 were randomized to receive standard therapy [ group B,n=23,18 males,mean age(62.72 ±11.48)years ] or standard therapy plus intracoronary administration of anisodamine [ 200 μg/ml,group A,n=24,18 males,mean age(64.23±12.27)years].The left ventriculography(LVG)was performed immediately and 6 months after PCI to measure the ventricular volume,LVEDP and wall motion score (WMS).Equilibrium radionuclide angiography(ERNA)was performed 1 week and 6 months after PCI to determine the parameters of left ventricular regional,global systolic function and systolic synchrony. Incidence of major adverse cardiac events(MACE)during the follow-up was analyzed.Results Anisodamine [(2530±340)μg/person)] was well tolerated by patients.The MBG remained unchanged in group B and significantly increased from grade 0.74±0.32 to grade 2.33±0.28 10 min after anisodamine injection in group B.Six months post PCI,LVESVI[(40.53±8.12)ml/m~2 vs.(50.32±8.26)ml/m~2], LVEDVI[(80.13±9.74)ml/m~2 vs.(87.17±10.25)ml/m~2 ],WMS [(8.24±1.31)vs.(10.23± 1.82)] and LVEDP [(13.36±4.21)vs.(16.38±3.21)mm Hg,1 mm Hg=0.133 kPa]were significantly lower in group A compared with that in group B(all P0.05)while LVEF [(44.02± 5.86)% vs.(38.52±5.18)%],PER [(1.86±0.09)EDV/s vs.(1.61±0.09)EDV/s] and PFR [(2.19±0.32)EDV/s vs.(1.78±0.17)EDV/s] measured by ERNA were signifieantly increased in group A compared with that in group B(all P0.05).(2)LrEF_2-LrEF_8 in group A were higher by 13.96%、25.02%、30.36%、22.86%、27.67%、22.07% and 18.71% respectively compared with that in group B.(3)Phase analysis showed that the left ventricular systolic synchrony parameters PS[(46.04± 8.93)° vs.(53.19±162)°],FWHM [(23.02±6.27)° vs.(25.02±5.31)°] and PSD [(7.92± 4.12)° vs.(11.76±4.11)°] were also significantly lower in group A than that in group B(all P 0.05).(4)During the 6 months of follow-up,the incidence of MACE in group A was significantly lower than that in group B(P0.05).Conclusion Intracoronary administration of anisodamine is safe and could partly attenuate the no-reflow phenomenon,improve the left ventricular systolic function and synchrony and reduce the incidence of MACE in patients with no-reflow phenomenon post AMI-PCI.