Microvascular resistance reserve in the presence of functionally significant epicardial stenosis and changes after revascularization.
Physiol Rep
; 11(5): e15627, 2023 03.
Article
en En
| MEDLINE
| ID: mdl-36905154
ABSTRACT
In the presence of functionally significant epicardial lesions, microvascular resistance reserve (MRR) calculation needs incorporation of collateral flow. Coronary fractional flow reserve (FFRcor ) requiring coronary wedge pressure (Pw ), which is an essential part of the true MRR calculation, is reportedly estimated by myocardial FFR (FFRmyo ) not requiring Pw measurement. We sought to find an equation to calculate MRR without the need for Pw . Furthermore, we assessed changes in MRR after percutaneous coronary intervention (PCI). An equation to estimate FFRcor was developed from a cohort of 230 patients who underwent physiological measurements and PCI. Corrected MRR was calculated using this equation and compared with true MRR in 115 patients of the different set of the validation cohort. True MRR was calculated using FFRcor . FFRcor and FFRmyo showed a strong linear relationship (r2 = 0.86) and an equation was FFRcor = 1.36 × FFRmyo - 0.34. This equation provided no significant difference between corrected MRR and true MRR in the validation cohort. Pre-PCI lower coronary flow reserve and higher index of microcirculatory resistance were independent predictors of pre-PCI decreased true MRR. True MRR significantly decreased after PCI. In conclusion, MRR can be accurately corrected using an equation for FFRcor estimation without Pw .
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Estenosis Coronaria
/
Reserva del Flujo Fraccional Miocárdico
/
Intervención Coronaria Percutánea
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Physiol Rep
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón