Document Detail


Maximal myocardial perfusion by videodensitometry in the assessment of the early and late results of coronary angioplasty: relationship with coronary artery measurements and left ventricular function at rest.
MedLine Citation:
PMID:  7621539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the assessment of the acute results of percutaneous transluminal coronary angioplasty (PTCA), myocardial perfusion at maximal vasodilatation theoretically has fewer limitations than the coronary flow reserve measurements and quantitative coronary angiography. The purpose of this study was to compare the myocardial perfusion to the measurements of the severity of the lesion (minimal luminal diameter and percent area stenosis) and to relate it to the changes of left ventricular function after PTCA. Regional myocardial perfusion was assessed during intracoronary papaverine, using the inverse mean transit time of contrast medium (1/Tmn), before, 15 min after, 18-24 hr after, and 6 months after successful single-vessel PTCA in 14 patients with stable angina. Left ventricular angiography (before angioplasty, 18-24 hr after, and 6 months later) was analysed by area-length and centerline methods. Immediately after PTCA, 1/Tmn increased from 0.14 +/- 0.07 sec-1 to 0.21 +/- 0.09 sec-1 (P = .001). Maximal myocardial perfusion remained higher than the pre-PTCA value the day after angioplasty (1/Tmn of 0.23 +/- 0.09 sec-1), while it reduced to near pre-PTCA values at follow-up (1/Tmn of 0.16 +/- 0.05 sec-1). Before PTCA, three out of ten patients had ejection fraction of < 65%, and seven had mild-to-moderate hypokinesis. The day after PTCA the ejection fraction and the regional dysfunction improved significantly. The change in ejection fraction 18-24 hr after PTCA did not correlate with minimal luminal diameter and percent area stenosis and correlated slightly with the improvement of perfusion (r = 0.54, P = .10). At follow-up left ventricular function deteriorated in the whole group, despite the persistence of angiographic success of PTCA, possibly because of changes in the loading condition. Coronary artery stenosis measurements and 1/Tmn failed to correlate with the left ventricular function. Given the difficulties in routine application of the analysis of time-density curves, the measurement of minimal luminal diameter remains a more practical assessment of the results of the intervention. However, the improvement of myocardial perfusion may give more information than coronary artery dimensions of the early recovery of left ventricular function.
Authors:
C Vassanelli; G Menegatti; J Molinari; G Zanotto; L Zanolla; I Loschiavo; P Zardini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  34     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-08-31     Completed Date:  1995-08-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  301-10; discussion 311-2     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of Verona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / physiopathology,  radiography,  therapy*
Angiography, Digital Subtraction*
Angioplasty, Transluminal, Percutaneous Coronary*
Blood Flow Velocity / physiology
Cineangiography
Coronary Angiography*
Coronary Disease / physiopathology,  radiography,  therapy*
Female
Follow-Up Studies
Hemodynamics / physiology*
Humans
Male
Middle Aged
Papaverine / diagnostic use
Radiographic Image Interpretation, Computer-Assisted
Ventricular Function, Left / physiology*
Video Recording*
Chemical
Reg. No./Substance:
58-74-2/Papaverine

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


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