Document Detail


Fractional myocardial flow reserve (FFRmyo) after coronary intervention as a predictor of chronic restenosis.
MedLine Citation:
PMID:  10745591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The angiographic assessment of coronary stenosis has many limitations, especially after coronary intervention. To determine the physiologic significance of such lesions, we measured the mean translesional pressure gradients at rest (P1), those during hyperemia induced by intracoronary administration of papaverine (12 mg in the left and 8 mg in the right coronary artery) (P2), and fractional myocardial flow reserve (FFRmyo) which is derived from the ratio of the mean distal coronary pressure and aortic pressure during hyperemia. Our objective was to determine the relations among P1, P2, and FFRmyo and restenosis as potential predictors of chronic restenosis. The grouped study consisted of 32 patients with ischemic heart disease scheduled to undergo intervention. The distal coronary pressure was measured using a 0.014 inch pressure monitoring wire (Pressure Guide, Radi Medical Systems, Uppsala, Sweden). The guidewire was advanced through the lesional segment. The mean percent diameter stenosis (%DS) was 67.9 +/- 13.3% before intervention and 22.9 +/- 15.3% after intervention. The mean P2 (9.9 +/- 5.3 mmHg) was significantly higher than the mean P1 (4.5 +/- 3.6 mmHg; p < 0.0001). There was no correlation of P1, P2 or FFRmyo with the %DS after intervention. Follow-up angiography (after 6 months) performed on all patients revealed restenosis (%DS > or =50%) in four patients (12.5%). There was no correlation between P1 and the %DS at the follow-up angiography, but the relation between P2, FFRmyo and the %DS at the follow-up angiography was significant (r = 0.599, p < 0.01; r = 0.703, p < 0.0001, respectively). As a measurement of P2, FFRmyo is useful for the determination of the endpoint of intervention in consideration of prevention of restenosis. A new endpoint may be established after further evaluation in a greater number of patients.
Authors:
H Fujita; N Inoue; Y Matsuo; T Tokura; T Tanaka; B Ohta; A M Matsumuro; T Kuriyama; M Kitamura; K Miyao
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  11     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  2005-03-29     Completed Date:  2005-05-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  527-32     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kyoto Second Red Cross Hospital, Kamigyo-ku, Kamanza-dori, Marutamachi, Kyoto 602-8026, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Blood Flow Velocity / physiology
Coronary Circulation / physiology*
Coronary Restenosis / physiopathology,  therapy*
Coronary Vessels / physiopathology*
Female
Humans
Male
Middle Aged
Predictive Value of Tests

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