| Simultaneous Doppler and pressure recordings to assess microvascular dysfunction in chronic total coronary occlusions--potential for recovery during follow-up. | |
| | |
MedLine Citation:
|
PMID: 12641026 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Microvascular dysfunction (MD) is frequently observed in chronic total coronary occlusions (TCOs). This impairs the use of Doppler velocimetry for the guidance of PTCA. It is yet unknown to what extent microvascular dysfunction may recover during follow-up, and whether this may influence long-term outcome. METHODS: After recanalization and stenting of TCOs (duration > 4 weeks) in 56 patients, coronary flow velocity reserve (CFVR) and fractional flow reserve (FFR) were recorded. MD was defined as a CFVR < 2.0 in the absence of a significant epicardial lesion (FFR > or = 0.75). Patients were followed for 5.3 +/- 1.5 months with reassessment of CFVR, FFR, and of LV function during a repeat angiography. RESULTS: MD was observed in 50% after PTCA. The CFVR improved during follow-up from 1.93 +/- 0.62 to 2.35 +/- 0.69 (p < 0.001), with a decrease of baseline APV (31.0 +/- 13.6 cm/s to 25.7 +/- 15.0 cm/s; p = 0.022). At follow-up MD was observed less frequently (20%). In 20 of 36 patients with initially impaired LV function, the ejection fraction (LVEF) improved. The CFVR at baseline did not predict LV recovery. Target vessel failure (restenosis > 50% diameter stenosis) occurred in 43%. CFVR did not predict TVF, but FFR tended to be lower in patients with TVF. In 8 patients with FFR > or = 0.93 after recanalization, no TVF was required. CONCLUSIONS: MD improved in more than 50% with initially impaired MD after PTCA during a long-term follow-up. CFVR at baseline was not closely related to LV recovery. The high rate of TVF was not predictable by CFVR. The FFR may be more valuable for optimizing PTCA in TCOs than Doppler parameters. |
| | |
Authors:
|
Gerald S Werner |
Related Documents
:
|
2939706 - Assessment of regional myocardial perfusion with thallium imaging during transient left... 1541446 - Restenosis after percutaneous transluminal coronary angioplasty. 2306846 - Myocardial dysfunction during percutaneous transluminal coronary angioplasty. 8956296 - Coronary artery disease in dialysis patients. 23141496 - The circulating level of fabp3 is an indirect biomarker of microrna-1. 22693326 - Cardiac tamponade as an initial manifestation of systemic lupus erythematosus. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Zeitschrift für Kardiologie Volume: 91 Suppl 3 ISSN: 0300-5860 ISO Abbreviation: Z Kardiol Publication Date: 2002 |
Date Detail:
|
Created Date: 2003-03-18 Completed Date: 2003-03-28 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0360430 Medline TA: Z Kardiol Country: Germany |
Other Details:
|
Languages: eng Pagination: 120-5 Citation Subset: IM |
Affiliation:
|
Klinik für Innere Medizin III, Friedrich-Schiller-Universität, Erlanger Allee 101, 07740 Jena, Germany. gerald.werner@med.uni-jena.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Analysis of Variance Angioplasty, Transluminal, Percutaneous Coronary* Blood Pressure* Coronary Circulation* Coronary Disease / physiopathology*, therapy* Data Interpretation, Statistical Female Follow-Up Studies Humans Laser-Doppler Flowmetry* Male Microcirculation Middle Aged Risk Assessment Time Factors Treatment Outcome Ventricular Function, Left / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Safety of FFR-based treatment strategies: the Munich experience.
Next Document: Early detection of myocardial microcirculatory disturbances after primary PTCA in patients with acut...