| Postprocedural resistance of the target lesion is a strong predictor of subsequent revascularization: assessment by a novel lesion-specific physiological parameter, the epicardial resistance index. | |
| | |
MedLine Citation:
|
PMID: 17533516 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Objective evaluation of the functional significance of individual stenosis in patients with multiple lesions is crucial when performing percutaneous coronary intervention (PCI). Here we propose a novel lesion-specific parameter, the epicardial resistance index (ERI), which is derived from intracoronary pressure measurements, and validate its clinical usefulness. The ERI is defined as the ratio of the resistance of an epicardial coronary stenosis to that of downstream myocardium. After obtaining intracoronary pressure data by pull-back of a 0.014'' pressure wire, the ERI was calculated as the trans-lesional pressure gradient divided by (Pd-Pv) at maximum hyperemia, where Pd = the mean distal coronary pressure in the absence of any stenosis and Pv = the central venous pressure. Using 170 measurements obtained from 75 patients, the correlation of ERI with parameters obtained from quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) was studied. ERI showed a significant correlation with the QCA-derived percent diameter stenosis (r = 0.67, P < 0.001), and with the IVUS-derived minimum luminal area (r = 0.68, P < 0.001). In 55 patients who underwent PCI with bare metal stents, a postprocedural target lesion ERI value greater than 0.16 strongly predicted the need for subsequent revascularization within six months (81% sensitivity and 80% specificity). The ERI is a useful pressure-derived hemodynamic parameter that correlates with anatomical parameters. In addition, the postprocedural resistance of the target lesion indicated by the ERI is a reliable predictor of the late outcome of PCI. |
| | |
Authors:
|
Kazuhito Suzuki; Yukio Tsurumi; Yuji Fuda; Yasuhiro Ishii; Atsushi Takagi; Nobuhisa Hagiwara; Hiroshi Kasanuki |
Related Documents
:
|
7895236 - Sympathetic influences on the native canine coronary collateral circulation. 9701896 - Mathematical analysis of reactive hyperaemia in the isolated rat heart with & without e... 7797416 - Contractile responses to electrolyte changes during coronary bolus perfusion. a compara... 8425996 - Effect of increases in heart rate and arterial pressure on coronary flow reserve in hum... 8179146 - Improving the induction characteristics of methohexitone. a study of the effect of addi... 2107616 - Symptomatology during hypoxic exposure to flame-retardant chamber atmospheres. |
Publication Detail:
|
Type: Journal Article Date: 2007-05-21 |
Journal Detail:
|
Title: Heart and vessels Volume: 22 ISSN: 0910-8327 ISO Abbreviation: Heart Vessels Publication Date: 2007 May |
Date Detail:
|
Created Date: 2007-05-29 Completed Date: 2007-10-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8511258 Medline TA: Heart Vessels Country: Japan |
Other Details:
|
Languages: eng Pagination: 139-45 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Coronary Angiography Coronary Restenosis / physiopathology, radiography, ultrasonography Coronary Stenosis / physiopathology*, radiography, surgery*, ultrasonography Female Humans Male Middle Aged Myocardial Revascularization / methods Predictive Value of Tests Pressure ROC Curve Regression Analysis Sensitivity and Specificity Severity of Illness Index* Stents Ultrasonography, Interventional Vascular Resistance / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Embryotoxic effects of nonylphenol and octylphenol in sea urchin Arbacia lixula.
Next Document: Efficacy and safety of low-dose pioglitazone after primary coronary angioplasty with the use of bare...