Document Detail


Myocardial contrast echocardiography assessment of acute changes in collateral perfusion of contralateral coronary artery with coronary flow reserve after coronary angioplasty.
MedLine Citation:
PMID:  16003265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary flow velocity reserve (CFVR) is used to evaluate the severity of epicardial and intramyocardial coronary artery disease. Collateral flow to an adjacent compromised myocardial territory may influence the CFVR of a specific artery. METHODS: To assess the impact of collateral flow on CFVR, we measured CFVR and assessed perfusion area (PA) with myocardial contrast echocardiography in the right coronary arteries of 18 patients with total/subtotal occlusion of the left anterior descending coronary artery before and after angioplasty. A total of 10 patients had well-developed collaterals emerging from the right coronary artery (group I) and 8 patients did not (group II). Using a Doppler-tipped guidewire, we measured CFVR, which is defined as the ratio of papaverine-induced hyperemic average peak velocity of coronary flow to baseline. RESULTS: Before angioplasty of the left anterior descending coronary artery, CFVR was significantly reduced in group I compared with group II (2.35 +/- 0.47 vs 3.26 +/- 0.54, P < .01). Baseline average peak velocity in group I before angioplasty was significantly greater than that after angioplasty (23.7 +/- 11.6 vs 19.2 +/- 9.7 cm/s, P < .05). After angioplasty, CFVR immediately increased in group I to 3.46 +/- 0.54 ( P < .001). The increase in CFVR was well correlated with the decrement in PA after angioplasty (r = 0.883, P < .001). CONCLUSION: The CFVR of an artery that supplies extensive collaterals is limited because of an elevation in the baseline resting flow velocity. This restriction in CFVR improves proportionally with decreases in PA that occurs after angioplasty of the ipsilateral coronary artery. These data suggest that PA, in addition to coronary artery structure, influences CFVR.
Authors:
Fuminobu Ishikura; Yasuhiko Sakata; Yasushi Sakata; Atsushi Hirayama; Shintaro Beppu; Kazuhisa Kodama
Related Documents :
21562355 - Displacement-calcium-nodules-native-valve-possible-cause-left-main-occlusion-following-...
9537535 - Elective or emergent interventional radiology through introducer sheath inserted during...
8013675 - Thrombosis and intrinsic fibrinolysis in percutaneous transluminal angioplasty.
1404045 - Percutaneous angioplasty in a district general hospital: impact and implications.
10592095 - Inhaled prostacyclin in the treatment of pulmonary hypertension.
9800355 - Sudden cardiac death due to atypical isolated coronary arteritis?
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  18     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-08     Completed Date:  2006-04-11     Revised Date:  2007-11-02    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  697-703     Citation Subset:  IM    
Affiliation:
School of Allied Health Sciences, Osaka University, Faculty of Medicine, Osaka, Japan. ishikura@sahs.med.osaka-u.ac.jp
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Blood Flow Velocity
Collateral Circulation*
Coronary Circulation*
Coronary Stenosis / surgery*,  ultrasonography*
Coronary Vessels / ultrasonography*
Echocardiography / methods*
Female
Humans
Male
Middle Aged
Prognosis
Treatment Outcome

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


Previous Document:  Echocardiographic methods for selecting patients suitable for biventricular pacing therapy.
Next Document:  A novel technique to detect total occlusion in the right coronary artery using retrograde flow by tr...