Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention

K. P. Balachandran; C. Berry; John David Norrie; B. D. Vallance; M. Malekianpour; T. J. Gilbert; A. C. H. Pell; K. G. Oldroyd

doi:10.1136/hrt.2003.023606

Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention

K. P. Balachandran, C. Berry, John David Norrie, B. D. Vallance, M. Malekianpour, T. J. Gilbert, A. C. H. Pell, K. G. Oldroyd

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Objective: To evaluate the relation between pressure derived coronary collateral flow (PDCF) index and angiographic TIMI ( thrombolysis in myocardial infarction) myocardial perfusion (TMP) grade, angiographic collateral grade, and subsequent recovery of left ventricular function after rescue percutaneous coronary intervention (PCI) for failed reperfusion in acute myocardial infarction.

Methods: The pressure wire was used as the guidewire in 38 consecutive patients who underwent rescue PCI between December 2000 and March 2002. Follow up angiography was performed at six months. Baseline and follow up single plane ventriculograms were analysed off line by an automated edge detection technique. A linear model was fitted to assess the relation between 0.1 unit increase in PDCF and change in left ventricular regional wall motion.

Results: Patients with TMP 0 grade had significantly higher mean (SD) PDCF than patients with TMP 1-3 (0.30 (0.11) v 0.15 (0.07), p < 0.0001, r = -0.5). A similar relation was observed between TMP grade and coronary wedge pressure ( mean ( SD) 28 ( 16) mm Hg with TMP 0 v 9 (7) mm Hg with TMP 1-3, p = 0.001, r = -0.4). Higher PDCF was associated with increased left ventricular end diastolic pressures (0.28 (0.14) with end diastolic pressure > 20 mm Hg v 0.22 (0.09) with end diastolic pressure > 20 mm Hg, p = 0.08, r = 0.2). No correlation was observed between PDCF and Rentrops collateral grade (0.26 (0.13) with grade 0 v 0.25 (0.11) with grades 1-3, p = 0.4, r = -0.06). No linear relation existed between changes in PDCF and changes in left ventricular regional wall motion.

Conclusion: PDCF in the setting of rescue PCI for failed reperfusion after thrombolysis does not predict improvement in left ventricular function. Increased PDCF and coronary wedge pressure in acute myocardial infarction reflect a dysfunctional microcirculation rather than good collateral protection.

Original language	English
Pages (from-to)	1450-1454
Number of pages	4
Journal	Heart
Volume	90
Issue number	12
DOIs	https://doi.org/10.1136/hrt.2003.023606
Publication status	Published - 2004

Keywords

ST SEGMENT RESOLUTION
BLOOD-FLOW
CONTRAST ECHOCARDIOGRAPHY
ISCHEMIC EVENTS
ARTERY-DISEASE
INFARCTION
RECOVERY
ANGIOPLASTY
RESERVE
INTRACORONARY

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10.1136/hrt.2003.023606

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Balachandran, K. P., Berry, C., Norrie, J. D., Vallance, B. D., Malekianpour, M., Gilbert, T. J., Pell, A. C. H., & Oldroyd, K. G. (2004). Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention. Heart, 90(12), 1450-1454. https://doi.org/10.1136/hrt.2003.023606

@article{206aadc20234475ea92f6c120c984d3c,

title = "Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention",

abstract = "Objective: To evaluate the relation between pressure derived coronary collateral flow (PDCF) index and angiographic TIMI ( thrombolysis in myocardial infarction) myocardial perfusion (TMP) grade, angiographic collateral grade, and subsequent recovery of left ventricular function after rescue percutaneous coronary intervention (PCI) for failed reperfusion in acute myocardial infarction.Methods: The pressure wire was used as the guidewire in 38 consecutive patients who underwent rescue PCI between December 2000 and March 2002. Follow up angiography was performed at six months. Baseline and follow up single plane ventriculograms were analysed off line by an automated edge detection technique. A linear model was fitted to assess the relation between 0.1 unit increase in PDCF and change in left ventricular regional wall motion.Results: Patients with TMP 0 grade had significantly higher mean (SD) PDCF than patients with TMP 1-3 (0.30 (0.11) v 0.15 (0.07), p < 0.0001, r = -0.5). A similar relation was observed between TMP grade and coronary wedge pressure ( mean ( SD) 28 ( 16) mm Hg with TMP 0 v 9 (7) mm Hg with TMP 1-3, p = 0.001, r = -0.4). Higher PDCF was associated with increased left ventricular end diastolic pressures (0.28 (0.14) with end diastolic pressure > 20 mm Hg v 0.22 (0.09) with end diastolic pressure > 20 mm Hg, p = 0.08, r = 0.2). No correlation was observed between PDCF and Rentrops collateral grade (0.26 (0.13) with grade 0 v 0.25 (0.11) with grades 1-3, p = 0.4, r = -0.06). No linear relation existed between changes in PDCF and changes in left ventricular regional wall motion.Conclusion: PDCF in the setting of rescue PCI for failed reperfusion after thrombolysis does not predict improvement in left ventricular function. Increased PDCF and coronary wedge pressure in acute myocardial infarction reflect a dysfunctional microcirculation rather than good collateral protection.",

keywords = "ST SEGMENT RESOLUTION, BLOOD-FLOW, CONTRAST ECHOCARDIOGRAPHY, ISCHEMIC EVENTS, ARTERY-DISEASE, INFARCTION, RECOVERY, ANGIOPLASTY, RESERVE, INTRACORONARY",

author = "Balachandran, {K. P.} and C. Berry and Norrie, {John David} and Vallance, {B. D.} and M. Malekianpour and Gilbert, {T. J.} and Pell, {A. C. H.} and Oldroyd, {K. G.}",

year = "2004",

doi = "10.1136/hrt.2003.023606",

language = "English",

volume = "90",

pages = "1450--1454",

journal = "Heart",

issn = "1355-6037",

publisher = "BMJ Publishing Group",

number = "12",

}

TY - JOUR

T1 - Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention

AU - Balachandran, K. P.

AU - Berry, C.

AU - Norrie, John David

AU - Vallance, B. D.

AU - Malekianpour, M.

AU - Gilbert, T. J.

AU - Pell, A. C. H.

AU - Oldroyd, K. G.

PY - 2004

Y1 - 2004

N2 - Objective: To evaluate the relation between pressure derived coronary collateral flow (PDCF) index and angiographic TIMI ( thrombolysis in myocardial infarction) myocardial perfusion (TMP) grade, angiographic collateral grade, and subsequent recovery of left ventricular function after rescue percutaneous coronary intervention (PCI) for failed reperfusion in acute myocardial infarction.Methods: The pressure wire was used as the guidewire in 38 consecutive patients who underwent rescue PCI between December 2000 and March 2002. Follow up angiography was performed at six months. Baseline and follow up single plane ventriculograms were analysed off line by an automated edge detection technique. A linear model was fitted to assess the relation between 0.1 unit increase in PDCF and change in left ventricular regional wall motion.Results: Patients with TMP 0 grade had significantly higher mean (SD) PDCF than patients with TMP 1-3 (0.30 (0.11) v 0.15 (0.07), p < 0.0001, r = -0.5). A similar relation was observed between TMP grade and coronary wedge pressure ( mean ( SD) 28 ( 16) mm Hg with TMP 0 v 9 (7) mm Hg with TMP 1-3, p = 0.001, r = -0.4). Higher PDCF was associated with increased left ventricular end diastolic pressures (0.28 (0.14) with end diastolic pressure > 20 mm Hg v 0.22 (0.09) with end diastolic pressure > 20 mm Hg, p = 0.08, r = 0.2). No correlation was observed between PDCF and Rentrops collateral grade (0.26 (0.13) with grade 0 v 0.25 (0.11) with grades 1-3, p = 0.4, r = -0.06). No linear relation existed between changes in PDCF and changes in left ventricular regional wall motion.Conclusion: PDCF in the setting of rescue PCI for failed reperfusion after thrombolysis does not predict improvement in left ventricular function. Increased PDCF and coronary wedge pressure in acute myocardial infarction reflect a dysfunctional microcirculation rather than good collateral protection.

AB - Objective: To evaluate the relation between pressure derived coronary collateral flow (PDCF) index and angiographic TIMI ( thrombolysis in myocardial infarction) myocardial perfusion (TMP) grade, angiographic collateral grade, and subsequent recovery of left ventricular function after rescue percutaneous coronary intervention (PCI) for failed reperfusion in acute myocardial infarction.Methods: The pressure wire was used as the guidewire in 38 consecutive patients who underwent rescue PCI between December 2000 and March 2002. Follow up angiography was performed at six months. Baseline and follow up single plane ventriculograms were analysed off line by an automated edge detection technique. A linear model was fitted to assess the relation between 0.1 unit increase in PDCF and change in left ventricular regional wall motion.Results: Patients with TMP 0 grade had significantly higher mean (SD) PDCF than patients with TMP 1-3 (0.30 (0.11) v 0.15 (0.07), p < 0.0001, r = -0.5). A similar relation was observed between TMP grade and coronary wedge pressure ( mean ( SD) 28 ( 16) mm Hg with TMP 0 v 9 (7) mm Hg with TMP 1-3, p = 0.001, r = -0.4). Higher PDCF was associated with increased left ventricular end diastolic pressures (0.28 (0.14) with end diastolic pressure > 20 mm Hg v 0.22 (0.09) with end diastolic pressure > 20 mm Hg, p = 0.08, r = 0.2). No correlation was observed between PDCF and Rentrops collateral grade (0.26 (0.13) with grade 0 v 0.25 (0.11) with grades 1-3, p = 0.4, r = -0.06). No linear relation existed between changes in PDCF and changes in left ventricular regional wall motion.Conclusion: PDCF in the setting of rescue PCI for failed reperfusion after thrombolysis does not predict improvement in left ventricular function. Increased PDCF and coronary wedge pressure in acute myocardial infarction reflect a dysfunctional microcirculation rather than good collateral protection.

KW - ST SEGMENT RESOLUTION

KW - BLOOD-FLOW

KW - CONTRAST ECHOCARDIOGRAPHY

KW - ISCHEMIC EVENTS

KW - ARTERY-DISEASE

KW - INFARCTION

KW - RECOVERY

KW - ANGIOPLASTY

KW - RESERVE

KW - INTRACORONARY

U2 - 10.1136/hrt.2003.023606

DO - 10.1136/hrt.2003.023606

M3 - Article

SN - 1355-6037

VL - 90

SP - 1450

EP - 1454

JO - Heart

JF - Heart

IS - 12

ER -

Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention

Abstract

Keywords

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