Document Detail


Influence of percutaneous coronary intervention on coronary microvascular resistance index.
MedLine Citation:
PMID:  15611371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary microvascular resistance during maximal hyperemia is generally assumed to be unaffected by percutaneous coronary interventions (PCIs). We assessed a velocity-based index of hyperemic microvascular resistance (h-MR(v)) by using prototypes of a novel, dual-sensor (Doppler velocity and pressure)-equipped guidewire before and after PCI to test this hypothesis. METHODS AND RESULTS: Aortic pressure, flow velocity (h-v), and pressure (h-P(d)) distal to 24 coronary lesions were measured simultaneously during maximal hyperemia induced by intracoronary adenosine. Measurements were obtained in the reference vessel before PCI and in the target vessel before and after PCI, stenting, and ultrasound-guided, upsized stenting. h-P(d) increased from 57.9+/-17.0 to 85.5+/-15.6 mm Hg, and h-MR(v) (ie, h-P(d)/h-v) decreased from 2.74+/-1.40 to 1.58+/-0.61 mm Hg x cm(-1) . s after stenting (both P<0.001). The reduction in h-MR(v) accounted for 34% of the decrease in total coronary resistance achieved by PCI. h-MR(v) of the target vessel after PCI was lower than that of the corresponding reference vessel despite a higher h-P(d) in the reference vessel (P<0.01). Post-PCI baseline MR(v) was correlated with baseline P(d) before PCI (P<0.01). CONCLUSIONS: PCI-induced restoration of P(d) resulted in a reduction of h-MR(v) in accordance with the pressure dependence of h-MR(v). The decrease in h-MR(v) to a level below that of the corresponding reference vessel in the immediate post-PCI period and a lowered baseline MR(v) suggest microvascular remodeling induced by long-term exposure to a low-pressure environment.
Authors:
Bart-Jan Verhoeff; Maria Siebes; Martijn Meuwissen; Bektas Atasever; Michiel Voskuil; Robbert J de Winter; Karel T Koch; Jan G P Tijssen; Jos A E Spaan; Jan J Piek
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-12-20
Journal Detail:
Title:  Circulation     Volume:  111     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-04     Completed Date:  2005-06-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  76-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use
Aged
Angina Pectoris / physiopathology,  therapy
Angioplasty, Transluminal, Percutaneous Coronary* / instrumentation
Blood Pressure
Coronary Angiography
Coronary Circulation*
Coronary Vessels / physiopathology*
Female
Hemodynamics
Humans
Hyperemia / physiopathology
Male
Microcirculation
Middle Aged
Stents
Ultrasonography, Interventional
Vascular Resistance*
Vasodilator Agents / diagnostic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

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


Previous Document:  Transgenic mouse model of ventricular preexcitation and atrioventricular reentrant tachycardia induc...
Next Document:  Protective role of angiopoietin-1 in endotoxic shock.