| Relation of the Systemic Blood Pressure to the Collateral Pressure Distal to an Infarct-Related Coronary Artery Occlusion During Acute Myocardial Infarction. | |
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MedLine Citation:
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PMID: 23178051 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Collaterals to occluded coronary arteries have been observed early after the onset of acute myocardial infarction (AMI). The pressure distal to the occluded segment of the culprit coronary artery (P(d)) is generated by collateral flow from the feeding coronary artery supplied by the systemic circulation. The aim of the study was to assess the relation between systemic blood pressure (BP) and P(d). Systemic BP and P(d) were measured simultaneously during intervention of totally occluded coronary arteries in 152 patients admitted for AMI. Patients were divided into groups by time from symptom onset to P(d) measurement. There was a significant positive correlation between P(d) and the systolic, diastolic, and mean BPs measured during the first 3 hours from symptom onset (n = 60; p <0.05, p <0.006, and p <0.005, respectively), from 3 to 12 hours (n = 56; p <0.02 for all), and >12 hours after symptom onset (n = 36; p <0.003 for all). The collateral flow, represented by calculated collateral flow index (mean 0.37 ± 0.14, median 0.36), was correlated with mean BP (p = 0.05) but not with diastolic or systolic BP (p = NS) in the overall study population. A direct relation was established during AMI between systemic BP and P(d) at all time intervals from symptom onset. Collateral flow index correlated with mean BP and was strongly associated with P(d) at all time intervals. In conclusion, the relation between P(d) and systemic BP suggests caution when administering therapy that may lower systemic BP during AMI before restoring flow in the occluded culprit artery, as it may compromise collateral pressure and exacerbate myocardial ischemia. |
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Authors:
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Simcha Ron Meisel; Aaron Frimerman; David Simeon Blondheim; Avraham Shotan; Aya Asif; Jacob Shani; Yoseph Rozenman; Michael Shochat |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-22 |
Journal Detail:
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Title: The American journal of cardiology Volume: - ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Heart Institute, Hillel Yaffe Medical Center, Hadera, affiliated to the Rappaport Medical School, The Technion Israel Institute of Technology, Haifa, Israel. Electronic address: meisel@hy.health.gov.il. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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