| Epicardial stenosis severity does not affect minimal microcirculatory resistance. | |
| | |
MedLine Citation:
|
PMID: 15466646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Whether minimal microvascular resistance of the myocardium is affected by the presence of an epicardial stenosis is controversial. Recently, an index of microcirculatory resistance (IMR) was developed that is based on combined measurements of distal coronary pressure and thermodilution-derived mean transit time. In normal coronary arteries, IMR correlates well with true microvascular resistance. However, to be applicable in the case of an epicardial stenosis, IMR should account for collateral flow. We investigated the feasibility of determining IMR in humans and tested the hypothesis that microvascular resistance is independent of epicardial stenosis. METHODS AND RESULTS: Thirty patients scheduled for percutaneous coronary intervention were studied. The stenosis was stented with a pressure guidewire, and coronary wedge pressure (P(w)) was measured during balloon occlusion. After successful stenting, a short compliant balloon with a diameter 1.0 mm smaller than the stent was placed in the stented segment and inflated with increasing pressures, creating a 10%, 50%, and 75% area stenosis. At each of the 3 degrees of stenosis, fractional flow reserve (FFR) and IMR were measured at steady-state maximum hyperemia induced by intravenous adenosine. A total of 90 measurements were performed in 30 patients. When uncorrected for P(w), an apparent increase in microvascular resistance was observed with increasing stenosis severity (IMR=24, 27, and 37 U for the 3 different degrees of stenosis; P<0.001). In contrast, when P(w) is appropriately accounted for, microvascular resistance did not change with stenosis severity (IMR=22, 23, and 23 U, respectively; P=0.28). CONCLUSIONS: Minimal microvascular resistance does not change with epicardial stenosis severity, and IMR is a specific index of microvascular resistance when collateral flow is properly taken into account. |
| | |
Authors:
|
Wilbert Aarnoudse; William F Fearon; Ganesh Manoharan; Maartje Geven; Frans van de Vosse; Marcel Rutten; Bernard De Bruyne; Nico H J Pijls |
Related Documents
:
|
10818636 - Computer modeling of fluid dynamics related to a myocardial bridge in a coronary artery. 3349576 - Transmural variation in autoregulation of right ventricular blood flow. 21183716 - Relationship between hot flashes and ambulatory blood pressure: the hilo women's health... 200436 - Smoking and catecholamine and c-amp concentrations in the coronary circulation of man a... 10877476 - Safety performance of gloves using the pressure tolerance of the hand. 8230326 - Experimental volume replacement through lower extremity veins. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2004-10-04 |
Journal Detail:
|
Title: Circulation Volume: 110 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Oct |
Date Detail:
|
Created Date: 2004-10-12 Completed Date: 2005-06-24 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 2137-42 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Transluminal, Percutaneous Coronary Collateral Circulation Constriction, Pathologic Coronary Circulation* Coronary Stenosis / therapy* Female Heart Catheterization Humans Male Microcirculation Middle Aged Pericardium / pathology* Pressure Thermodilution Vascular Resistance* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Giant fetal magnetocardiogram P waves in congenital atrioventricular block: a marker of cardiovascul...
Next Document: In situ Akt phosphorylation in the nucleus tractus solitarii is involved in central control of blood...