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ȣ - 490633 144 |
| Mechanisms of abnormal CFR after PCI |
| Department of Cardiology, School of Medicine, Ajou University, Suwon, Korea |
| Myeong-Ho Yoon, Seung-Jea Tahk, Seong-il Woo, Hong-Seok Lim, Jung-Hyun Choi, Sung-Gyun Ahn, Zhen-Guo Zheng, Soo-Jin Kang, Byoung-Joo Choi, So-Yeon Choi, Gyo-Seung Hwang, Joon-Han Shin |
Background: We evaluated the mechanisms for abnormal coronary flow reserve(CFR) after PCI in angina patient by measuring the cardiac enzyme(CE), reference(R) CFR, and microvascular resistance index(MVRI). Methods: We studied 82 angina patients assessed the CFR, MVRI of the target and R-vessels. Blood samplings were obtained immediately, 6, 12, 18, and 24 h after PCI. Elevated CE was difined as more than two times elevation of CK-MB compare to normal limits. The patients were divided into three groups; G 1: post-PCI CFR≥2.5 and normal CE, G 2: post-PCI CFR<2.5 and normal CE, G 3: elevated CE. Results: Post-PCI CK-MB was elevated 6.0% in total patients. In group 3, post-PCI CFR was lower than that of group 1 and R-CFR. In group 2, post-PCI bMVRI was lower than pre-PCI bMVRI. Also, post-PCI bMVRI was lower than R-bMVRI. However, in group 1, there was no difference between post-PCI bMVRI and pre-PCI bMVRI. Also, there was no difference between post-PCI bMVRI and R-bMVRI. Conclusion: A major portion of patients with abnormal CFR after PCI was related with failure of autoregulation, and a minor portion of patients was related with microvascular damage during PCI.
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G
1, n=51 |
G
2, n=26 |
G
3, n=5 |
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Pre-PCI |
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bMVRI(mmHg×cm-1×s) |
6.59±2.94 |
5.85±2.46 |
5.45±2.91 |
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hMVRI |
3.14±1.67† |
3.87±2.90 |
2.83±0.77 |
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CFR |
2.28±0.84 |
1.72±0.56* |
1.84±0.35 |
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Post-PCI |
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bMVRI |
6.58±2.25 |
3.96±1.23*‡§ |
5.63±2.01 |
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hMVRI |
1.87±0.77‡ |
2.12±0.74†‡ |
2.65±1.22 |
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CFR |
3.29±0.81‡ |
1.88±0.40*§ |
2.10±0.74†§ |
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Reference
vessel |
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bMVRI |
6.10±2.36 |
5.01±2.10* |
6.32±2.93 |
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hMVRI |
1.74±0.55 |
1.93±0.76 |
2.41±1.37 |
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CFR |
3.47±0.96 |
2.65±1.00* |
2.62±0.63 |
*:
p<0.05, G 1 vs. G 2. †: p<0.05, G 1 vs. G 3,
‡:
p<0.05, pre-PCI vs. post-PCI, §:
p<0.05, post-PCI vs. reference vessel, b: baseline, h:
hyperemia
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