| Single-wire pressure and flow velocity measurement to quantify coronary stenosis hemodynamics and effects of percutaneous interventions. | |
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MedLine Citation:
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PMID: 14970112 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Lack of high-fidelity simultaneous measurements of pressure and flow velocity distal to a coronary artery stenosis has hampered the study of stenosis pressure drop-velocity (DeltaP-v) relationships in patients. METHODS AND RESULTS: A novel 0.014-inch dual-sensor (pressure and Doppler velocity) guidewire was used in 15 coronary lesions to obtain per-beat averages of pressure drop and velocity after an intracoronary bolus of adenosine. DeltaP-v relations from resting to maximal hyperemic velocity were constructed before and after stepwise executed percutaneous coronary intervention (PCI). Before PCI, half of the DeltaP-v relations revealed the presence of a compliant stenosis, which was stabilized by angioplasty. Fractional flow reserve (FFR), coronary flow reserve (CFVR), and velocity-based indices of stenosis resistance (h-SRv) and microvascular resistance (h-MRv) at maximal hyperemia were compared. Stepwise PCI significantly lowered h-SRv, with an initial marked reduction in hyperemic pressure drop followed by further gains in velocity. A concomitant significant reduction of h-MRv accounted for half of the gain in velocity after PCI. The average magnitude of absolute incremental hemodynamic changes was highest for h-SRv (56.8+/-39.2%) compared with CFVR (35.3+/-34.5%, P<0.005) or FFR (19.5+/-25.2%, P<0.0001). CONCLUSIONS: DeltaP-v relations comprehensively visualize improvements in coronary hemodynamics after PCI. h-SRv is a powerful and sensitive descriptor of the functional gain achieved by PCI, combining information about both pressure gradient and velocity, which are oppositely affected by PCI. Simultaneous assessment of stenosis and microvascular resistance may provide a valuable tool for guidance of PCI. |
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Authors:
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Maria Siebes; Bart-Jan Verhoeff; Martijn Meuwissen; Robbert J de Winter; Jos A E Spaan; Jan J Piek |
Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 109 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-02-18 Completed Date: 2004-05-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 756-62 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. m.siebes@amc.uva.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Blood Flow Velocity Blood Pressure Coronary Angiography Coronary Circulation* Coronary Stenosis / diagnosis*, therapy* Female Heart Catheterization / instrumentation* Hemodynamics Humans Male Middle Aged |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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