Document Detail


Determinants of coronary arterial flow-mediated dilatation following percutaneous coronary intervention.
MedLine Citation:
PMID:  18288727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It has previously been observed that coronary diameter may increase following relief of flow-limiting obstruction. Flow mediated dilatation (FMD) is a fundamental adaptive mechanism for arteries, which is dependent on intact endothelial function. We thus aimed to characterize whether the degree of this flow-mediated dilatation was related to risk factors, which may impair endothelial function. DESIGN: We measured coronary diameter with quantitative angiography before and after relief of chronic total or subtotal (>or=99%) occlusion in 171 patients, in which TIMI-0 or TIMI-1 flow was rapidly restored to TIMI-3 (with attendant increase in flow hypothesized to result in FMD). PATIENTS: Of the 171 patients, 73% were male, 62% were current or ex-smokers, 47% were diabetic, 53% had hypertension, 64% had dyslipidemia (documented hypercholesterolemia or total cholesterol >5.0 mg/dL) and 65% were taking statin therapy. RESULTS: Mean vessel diameter was 2.8 +/- 0.7 mm and flow-mediated dilatation measured 15.1% +/- 20.1% in target vessel, compared with 1.6 +/- 3.1 in control vessels (P < 0.05). FMD was strongly and inversely related to baseline vessel diameter (r = -0.48, P < 0.001). The degree of vessel dilation correlated negatively with the presence of diabetes (r = -0.33, P < 0.001), smoking (r = -0.30, P < 0.001) and extent of coronary artery disease (CAD, r = -0.17, P = 0.01) and positively with the use of statins (r = 0.27, P = 0.001). These factors, apart from extent of CAD, remained significant predictors of FMD on multivariate analysis. CONCLUSIONS: FMD occurs in human coronary arteries following restoration of flow. The magnitude of FMD appears related to vascular risk factors and their treatment.
Authors:
Michele McGrady; Panuratn Thanyasiri; Brian P Bailey; David S Celermajer; Mark R Adams
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  71     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-26     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-32     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology at Royal Prince Alfred Hospital, Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary / methods
Blood Flow Velocity
Case-Control Studies
Cohort Studies
Coronary Angiography / methods*
Coronary Circulation / physiology*
Coronary Stenosis / mortality,  radiography*,  therapy*
Endothelium, Vascular / physiopathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Probability
Reference Values
Severity of Illness Index
Survival Rate
Treatment Outcome
Vascular Patency / physiology*
Vascular Resistance / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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