Effect of percutaneous coronary intervention on global hemodynamics and the prevalence of residual microvascular dysfunction.
Microcirculation
; 29(2): e12745, 2022 02.
Article
in En
| MEDLINE
| ID: mdl-34897893
ABSTRACT
OBJECTIVES:
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).METHODS:
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).RESULTS:
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.CONCLUSIONS:
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Fractional Flow Reserve, Myocardial
/
Percutaneous Coronary Intervention
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Microcirculation
Journal subject:
ANGIOLOGIA
Year:
2022
Type:
Article
Affiliation country:
Japan