کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2944110 1577076 2014 11 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of Microvascular Obstruction on the Assessment of Coronary Flow Reserve, Index of Microcirculatory Resistance, and Fractional Flow Reserve After ST-Segment Elevation Myocardial Infarction
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Impact of Microvascular Obstruction on the Assessment of Coronary Flow Reserve, Index of Microcirculatory Resistance, and Fractional Flow Reserve After ST-Segment Elevation Myocardial Infarction
چکیده انگلیسی

BackgroundInvasive assessment of coronary physiology (IACP) offers important prognostic insights in ST-segment elevation myocardial infarction (STEMI) but the dynamics of coronary recovery are poorly understood.ObjectivesThis study sought to examine the evolution of coronary flow reserve (CFR), index of microcirculatory resistance (IMR), ratio of distal coronary pressure (Pd) to mean aortic pressure (Pa), and fractional flow reserve (FFR) in patients undergoing primary percutaneous coronary intervention (PPCI).Methods82 patients with STEMI underwent IACP at PPCI. Repeat IACP was performed in 61 patients (74%) at day 1 and in 46 patients (56%) at 6 months. Contrast-enhanced cardiac magnetic resonance imaging (CMR) was performed in 45 patients (55%) at day 1 and in 41 patients (50%) at 6 months. Changes in IACP were compared between patients with and without microvascular obstruction (MVO) on CMR.ResultsMVO was present in 21 of 45 patients (47%). Patients with MVO had lower CFR at PPCI and day 1 (p < 0.05) and a trend toward higher IMR values (p = 0.07). At 6 months, CFR and IMR were not significantly different between the groups. Baseline flow and Pd/Pa remained stable over time but FFR reduced significantly between PPCI and 6 months (p = 0.008); this reduction was mainly observed in patients with MVO (p = 0.006) but not in those without MVO (p = 0.21).ConclusionsIn PPCI-treated patients with STEMI, coronary microcirculation begins to recover within 24 h and recovery progresses further by 6 months. FFR significantly reduces from baseline to 6 months. The presence of MVO indicates a highly dysfunctional microcirculation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 64, Issue 18, 4 November 2014, Pages 1894–1904
نویسندگان
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