Effect of percutaneous coronary intervention on global hemodynamics and the prevalence of residual microvascular dysfunction.
coronary flow reserve
coronary microvascular dysfunction
fractional flow reserve
percutaneous coronary intervention
stable coronary artery disease
Journal
Microcirculation (New York, N.Y. : 1994)
ISSN: 1549-8719
Titre abrégé: Microcirculation
Pays: United States
ID NLM: 9434935
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
28
11
2021
received:
15
09
2021
accepted:
07
12
2021
pubmed:
14
12
2021
medline:
25
3
2022
entrez:
13
12
2021
Statut:
ppublish
Résumé
We aimed to examine the changes in hyperemic coronary sinus flow (CSF) and global coronary flow reserve (g-CFR) after percutaneous coronary intervention (PCI) and investigate the predictors to improve these metrics and the prevalence of residual coronary microvascular dysfunction (CMD). This prospective, single-center study included 118 patients with stable coronary artery disease undergoing PCI for a single proximal lesion. Phase-contrast cine-cardiac magnetic resonance (PC-CMR) was used to assess hyperemic CSF (HCSF) and g-CFR, before and after PCI. Residual CMD was defined as concordantly impaired post-PCI HCSF (<2.3 ml/min/g) and g-CFR (<2.0). HCSF significantly increased, although 38 (32.2%) patients showed a decrease. There was no significant change in g-CFR despite fractional flow reserve (FFR) improvement in all target territories. Concordantly increased HCSF and g-CFR were effectively discriminated by adding PC-CMR-derived information to pre-PCI FFR. Residual CMD was observed in 30 (25.4%) patients and was associated with pre-PCI renal dysfunction and lower pre-PCI rest and hyperemic CSF, but not with pre-PCI regional physiological indices. FFR-guided PCI was associated with increased HCSF, but not with increased g-CFR. After uncomplicated PCI, one-quarter of patients showed residual CMD. Our approach may help identify patients who may benefit from increased coronary perfusion or show residual CMD.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12745Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
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