Document Detail


Impact of catheter sizes and intracoronary glyceryl trinitrate on the TIMI frame count when digital angiograms are acquired at lower frame rates during elective angiography and PCI.
MedLine Citation:
PMID:  17851976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The TIMI frame count (TFC) is a useful measure of coronary flow. To be widely applicable, the effect of different catheter sizes and the use of intracoronary glyceryl trinitrate (ICGTN) must be determined when films are acquired at lower acquisition rates (12.5 frames/s, f/s). METHODS: We compared 6F versus 5F diagnostic catheters (n = 44), 6F versus 7F diagnostic catheters (n = 45) and 6F diagnostic versus 7F guide catheters (n = 44). In the nitrate angiography group (n = 141), coronary angiography was performed before and after 200 micrograms of ICGTN. In the nitrate percutaneous coronary intervention (PCI) group (n = 48), coronary angiography was performed before and after 200 micrograms of ICGTN after the completion of the elective PCI procedure. RESULTS: The mean difference in the uncorrected TFC using 6F and 5F was 0.02 (95 % CI -0.5, 0.6; P = 0.9); using 6F and 7F diagnostic catheters it was 0.3 (95% CI -0.49, 1.1; p = 0.4); and using 6F diagnostic and 7F guide catheters it was 0.4 (95% CI -2.6, 3.4; P = 0.7) respectively. In the nitrate angiography group, the uncorrected TFC before and after ICGTN was 13.1+/-6.2 and 15+/-7.5 (equivalent to 31.4+/-14.9 and 36+/-2 at 30 f/s), with a mean difference of 1.9 (95% CI 1.3, 2.5; P = or <0.0001). In the nitrate PCI group, the uncorrected TFC before and after ICGTN administration was 9.2+/-3.7 and 10.3+/-4.2 (equivalent to 22.6+/-9.6 and 25.2+/-11 at 30 f/s) respectively with a mean difference between the two injections of 1.2 (95% CI -0.4, 1.9; P = 0.003). CONCLUSION: We have demonstrated that the catheter sizes did not significantly affect the TFC when angiography was performed at 12.5f/s. The use of ICGTN significantly increased the TFC in both normal and diseased coronary arteries. This effect was also observed when ICGTN was administered into the culprit vessels after the completion of the elective PCI procedure. This effect must be considered when investigating the impact of specific treatments or drugs on coronary flow.
Authors:
Kunadian Vijayalakshmi; Babu Kunadian; Victoria J Whittaker; Robert A Wright; James A Hall; Upendra Somasundram; Michael J Stewart; Andrew Sutton; Adrian Davies; Mark A de Belder
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  9     ISSN:  1748-2941     ISO Abbreviation:  Acute Card Care     Publication Date:  2007  
Date Detail:
Created Date:  2008-01-03     Completed Date:  2008-02-07     Revised Date:  2009-11-17    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  231-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, The James Cook University Hospital, Middlesbrough, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Coronary Angiography / instrumentation*
Coronary Circulation / drug effects,  physiology*
Coronary Stenosis / radiography,  surgery
Female
Heart Catheterization / instrumentation*
Humans
Male
Middle Aged
Nitroglycerin / diagnostic use*
Time Factors
Vasodilator Agents / diagnostic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin

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


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