Document Detail


The index of microvascular resistance identifies patients with periprocedural myocardial infarction in elective percutaneous coronary intervention.
MedLine Citation:
PMID:  22895644     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: This study was designed to assess whether measurement of the index of microvascular resistance (IMR) could help prospectively identify patients who develop periprocedural myocardial infarction (PPMI). METHODS AND RESULTS: IMR was measured in 54 patients before and following percutaneous coronary intervention (PCI) in a culprit vessel with a PressureWire using the equation IMR = Pa(Hyp) × Tmn(Hyp) (Pd(Hyp)-Pw/Pa(Hyp)-Pw). IMR was also measured in an angiographically normal reference vessel. The relative pre-IMR ratio (rPIMR) defined as IMR Culprit divided by IMR Non-Culprit was also calculated. Troponin was sequentially sampled up to 24 h following PCI. Mean troponin post-PCI was 0.37±0.8 ng/ml. 33 (61%) patients fulfilled the criteria for PPMI. IMR pre-PCI was the most significant correlate of post-PCI troponin (r=0.43 p=0.001), however, the number of balloon inflations (r=0.3, p=0.02) and rPIMR (r=0.33 p=0.017) were also correlated. IMR pre-PCI was higher in patients with periprocedural myocardial infarction compared with patients without PPMI (IMR pre-PCI 21.2±2.1 PPMI vs 15.6±1.8 No PPMI, p=0.02). The strongest predictor of troponin post-PCI was IMR pre-PCI (β 0.7, p=0.02). Both IMR pre- and rPIMR were predictive of PPMI (OR 11 (1.3 to 90.5) p=0.026, OR 1.09 (1 to 1.19) p=0.03, respectively). CONCLUSION: Microvascular function prior to PCI is an important determinant of PPMI. Measuring IMR pre-PCI and rPIMR may allow prospective identification of patients at risk of periprocedural myocardial infarction. Future studies in a larger cohort are required to establish the predictive ability of IMR in PPMI.
Authors:
Jamie J Layland; Robert J Whitbourn; Andrew T Burns; Jithendra Somaratne; Georg Leitl; Andrew I Macisaac; Andrew Wilson
Related Documents :
22595404 - Temporal trends in and factors associated with bleeding complications among patients un...
22764254 - Three-day csf drainage barely reduces ventricular size in normal pressure hydrocephalus.
22738144 - Right ventricular dysfunction following continuous flow left ventricular assist device ...
8877264 - Post-myocardial infarction trials: beta blockers, antiarrhythmics, thrombolytics.
2795534 - Psychophysiological factors in ventricular arrhythmias and sudden cardiac death.
2787324 - Single staged carotid and coronary arteries surgery. indications and results.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-15
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  -     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
St Vincent's Hospital, Fitzroy, Victoria, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Differences in performance of five types of aortic valve prostheses: haemodynamic assessment by dobu...
Next Document:  No relation between coronary artery disease or electrocardiographic markers of disease in middle age...