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Influence of epicardial stenosis severity and central venous pressure on the index of microcirculatory resistance in a follow-up study.
MedLine Citation:
PMID:  24457278     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aims: This study sought to evaluate the reproducibility of the index of microcirculatory resistance (IMR) in a follow-up model and the role of epicardial artery stenosis and central venous pressure (Pv) on IMR. Methods and results: Twenty-two patients with stable coronary artery disease underwent coronary catheterisation at baseline and after seven weeks. The IMR was calculated at baseline and follow-up in several ways: as IMRuncorrected=Pd·Tmn (Pd: intracoronary pressure distal to the stenosis; Tmn: transit mean time); IMRcorrected=Pa·Tmn·(Pd - Pw)/(Pa-Pw), (Pw: coronary wedge pressure; Pa: aortic pressure); and as IMRcentral venous pressure (IMRcvp)=(Pa-Pv)·Tmn·(Pd-Pw)/(Pa-Pw). By neglecting Pw, IMR was overestimated irrespective of the haemodynamic severity of the epicardial stenosis (baseline: IMRuncorrected=15.5±8.9 U vs. IMRcorrected=13.5±8 U, p<0.001; follow-up: IMRuncorrected=16.9±4.9 U vs. IMRcorrected=13.8±4.6 U, p<0.001). In the intra-individual analysis IMR did not differ between the two time points. The IMRcvp equalled the IMRcorrected at all time points. Conclusions: IMR is a reproducible index in follow-up studies, independent of any overestimation existing when collateral flow status is neglected. Pv can be neglected for calculation of the IMR.
Authors:
Nikolaos Pagonas; C Michael Gross; Mejing Li; Anja Bondke; Volker Klauss; Eva-Elina Buschmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  9     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  1063-8     Citation Subset:  IM    
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