| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
2 Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
3 Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
* To whom correspondence should be addressed. E-mail: j.j.piek{at}amc.uva.nl.
Homogeneity of microvascular resistance in different perfusion areas of the same heart is generally assumed. We investigated the effect of the severity of an epicardial stenosis on microvascular resistance in 27 patients with coronary artery disease and stable angina. All patients had an angiographically normal coronary artery, one intermediate lesion and one severe lesion; the latter was treated with angioplasty. In each patient, distal blood flow velocity and pressure were measured during baseline and maximal hyperemia (induced by i.c. adenosine), using a Doppler and pressure guidewire, respectively. The ratio of mean distal pressure to average peak blood flow velocity was used as an index for the microvascular resistance (MRv). Within patients, the hyperemic MRv was higher in arteries with more severe stenosis (p=0.021). After angioplasty, the hyperemic MRv decreased (pre PTCA, 2.6 vs. post PTCA, 1.9, p<0.01) towards the value of the reference artery (1.7; p=0.67). We conclude that there is a positive association between coronary lesion severity and variability of distal microvascular resistance that normalizes after angioplasty. This study challenges the concept of uniform distribution of hyperemic microvascular resistance that is relevant for the interpretation of both non-invasive and invasive diagnostic tests.
This article has been cited by other articles:
|
|
 |
|
  O. Sorop, D. Merkus, V. J. de Beer, B. Houweling, A. Pistea, E. O. McFalls, F. Boomsma, H. M. van Beusekom, W. J. van der Giessen, E. VanBavel, et al. Functional and Structural Adaptations of Coronary Microvessels Distal to a Chronic Coronary Artery Stenosis Circ. Res., April 11, 2008; 102(7): 795 - 803. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Marques, P. Knaapen, R. Boellaard, N. Westerhof, A. A. Lammertsma, C. A. Visser, and F. C. Visser Hyperaemic microvascular resistance is not increased in viable myocardium after chronic myocardial infarction Eur. Heart J., October 1, 2007; 28(19): 2320 - 2325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. H. J. Pijls Fractional flow reserve after previous myocardial infarction Eur. Heart J., October 1, 2007; 28(19): 2301 - 2302. [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Piek Beyond Epicardial Reperfusion N. Engl. J. Med., May 3, 2007; 356(18): 1880 - 1882. [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Kern, A. Lerman, J.-W. Bech, B. De Bruyne, E. Eeckhout, W. F. Fearon, S. T. Higano, M. J. Lim, M. Meuwissen, J. J. Piek, et al. Physiological Assessment of Coronary Artery Disease in the Cardiac Catheterization Laboratory: A Scientific Statement From the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology Circulation, September 19, 2006; 114(12): 1321 - 1341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K.C. Ng, A. C. Yeung, and W. F. Fearon Invasive Assessment of the Coronary Microcirculation: Superior Reproducibility and Less Hemodynamic Dependence of Index of Microcirculatory Resistance Compared With Coronary Flow Reserve Circulation, May 2, 2006; 113(17): 2054 - 2061. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.-J. Verhoeff, M. Siebes, M. Meuwissen, B. Atasever, M. Voskuil, R. J. de Winter, K. T. Koch, J. G.P. Tijssen, J. A.E. Spaan, and J. J. Piek Influence of Percutaneous Coronary Intervention on Coronary Microvascular Resistance Index Circulation, January 4, 2005; 111(1): 76 - 82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Aarnoudse, W. F. Fearon, G. Manoharan, M. Geven, F. van de Vosse, M. Rutten, B. De Bruyne, and N. H.J. Pijls Epicardial Stenosis Severity Does Not Affect Minimal Microcirculatory Resistance Circulation, October 12, 2004; 110(15): 2137 - 2142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Siebes, B.-J. Verhoeff, M. Meuwissen, R. J. de Winter, J. A.E. Spaan, and J. J. Piek Single-Wire Pressure and Flow Velocity Measurement to Quantify Coronary Stenosis Hemodynamics and Effects of Percutaneous Interventions Circulation, February 17, 2004; 109(6): 756 - 762. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
