Changes in absolute coronary blood flow and myocardial resistance after percutaneous coronary intervention
Abstract
BACKGROUND
Treating a coronary stenosis by percutaneous coronary intervention (PCI) aims to relieve myocardial ischaemia by improving coronary blood flow. The evolution of coronary flow and resistance post-PCI is not fully understood.
AIMS
This study aimed to investigate the immediate impact of PCI on absolute coronary flow (Q), and epicardial and microvascular resistance (Repi and Rμ).
METHODS
In a two-centre cohort including 52 patients, pre- and post-PCI physiological assessments were performed using continuous thermodilution, via a combination of a pressure-temperature sensor wire and a dedicated infusion microcatheter.
RESULTS
Resting Q remained similar before and after PCI (Δ +2 [interquartile range [IQR] -9 to 21] mL/min; p=0.21), as a 193 Wood unit (WU) reduction in resting Repi (Δ -193 [IQR -400 to -59] WU; p<0.001) was offset by a 267 WU increase in resting Rμ (Δ +267 [IQR -20 to 474] WU; p=0.002). Conversely, hyperaemic Q rose significantly (Δ +44 [IQR 16 to 92] mL/min; p<0.001), reflecting a 195 WU reduction in hyperaemic Repi (Δ -195 [IQR -379 to -82] WU; p<0.001), while hyperaemic Rμ remained stable (Δ +3 [IQR -96 to 75] WU; p=0.87). The median microvascular resistance reserve (MRR) did not change significantly after PCI (Δ -0.2 [IQR -0.7 to 0.6]; p=0.301). Pre- and post-PCI fractional flow reserve (FFR) were strongly and inversely associated with Repi and predicted the improvement of hyperaemic Q.
CONCLUSIONS
PCI significantly reduces epicardial resistance,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 52 participants or records.
Read the paper
Related studies
- A Coupled SYSTEM of Intracellular Ca 2+ Clocks and Surface Membrane Voltage Clocks Controls the Timekeeping Mechanism of the Heart’s Pacemaker
- A Comprehensive Review on the Therapeutic Potential of Curcuma longa Linn. in Relation to its Major Active Constituent Curcumin
- Cancer epigenetics: Moving forward
- Current developments in LC-MS for pharmaceutical analysis
- Myricetin: A comprehensive review on its biological potentials
- A Computational Systems Biology Software Platform for Multiscale Modeling and Simulation: Integrating Whole-Body Physiology, Disease Biology, and Molecular Reaction Networks
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.