Document Detail

Quantitative assessment of coronary microvascular function in patients with and without epicardial atherosclerosis.
MedLine Citation:
PMID:  20542779     Owner:  NLM     Status:  MEDLINE    
AIMS: The influence of atherosclerosis and its risk factors on coronary microvascular function remain unclear as current methods of assessing microvascular function do not specifically test the microcirculation in isolation. We examined the influence of epicardial vessel atherosclerosis on coronary microvascular function using the index of myocardial resistance (IMR). METHODS AND RESULTS: IMR (a measure of microvascular function) and fractional flow reserve (FFR, a measure of the epicardial compartment) were measured in 143 coronary arteries (116 patients). Fifteen patients (22 arteries, mean age 48+/-16 years) had no clinical evidence of atherosclerosis (control group). One hundred and one patients (121 arteries, mean age 63+/-11 years) had established atherosclerosis and multiple cardiovascular risk factors (atheroma group). Mean IMR in the control group (19+/-5, range 8-28) was significantly lower than in the atheroma group (25+/-13, range 6-75) (P<0.01). However, there was large overlap between IMR in both groups, with 69% of IMR values in patients with atheroma being within the control range. Mean FFR was also higher in the control group (0.96+/-0.02, range 0.93-1.00) than in the atheroma group (0.85+/-0.14, range 0.19-1.00) (P<0.01). There was no correlation between IMR and FFR (r=0.09; P=0.24), even when results in the control (r=0.02; P=0.92) and atheroma (r=0.15; P=0.10) groups were analysed in isolation. Using stepwise multiple regression analysis presence/absence of atheroma (ss=0.42; P=0.02) was the only independent determinant of IMR. CONCLUSIONS: Mean IMR is higher in patients with epicardial atherosclerosis. However, there is a large overlap between IMR in patients with and without epicardial atherosclerosis.
Narbeh Melikian; Stephen Vercauteren; William F Fearon; Thomas Cuisset; Philip A MacCarthy; Giedrius Davidavicius; Wilbert Aarnoudse; Jozef Bartunek; Marc Vanderheyden; Eric Wyffels; William Wijns; Guy R Heyndrickx; Nico H J Pijls; Bernard de Bruyne
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  5     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  939-45     Citation Subset:  IM    
Cardiovascular Center, OLV Hospital, Aalst, Belgium.
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MeSH Terms
Case-Control Studies
Chi-Square Distribution
Coronary Angiography
Coronary Artery Disease / diagnosis,  physiopathology*
Coronary Circulation*
Coronary Vessels / physiopathology*
Fractional Flow Reserve, Myocardial
Heart Catheterization
Hyperemia / physiopathology
Middle Aged
Regression Analysis
Risk Assessment
Risk Factors
Vascular Resistance
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Vasodilator Agents

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

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