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 journalArticle

    18 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 languageEnglish
    Pages (from-to)1450-1454
    Number of pages4
    JournalHeart
    Volume90
    Issue number12
    DOIs
    Publication statusPublished - 2004

    Keywords

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

    Cite this

    Balachandran, K. P., Berry, C., Norrie, J. D., Vallance, B. D., Malekianpour, M., Gilbert, T. J., ... 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

    Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention. / Balachandran, K. P.; Berry, C.; Norrie, John David; Vallance, B. D.; Malekianpour, M.; Gilbert, T. J.; Pell, A. C. H.; Oldroyd, K. G.

    In: Heart, Vol. 90, No. 12, 2004, p. 1450-1454.

    Research output: Contribution to journalArticle

    Balachandran, KP, Berry, C, Norrie, JD, Vallance, BD, Malekianpour, M, Gilbert, TJ, Pell, ACH & Oldroyd, KG 2004, 'Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention', Heart, vol. 90, no. 12, pp. 1450-1454. https://doi.org/10.1136/hrt.2003.023606
    Balachandran, K. P. ; Berry, C. ; Norrie, John David ; Vallance, B. D. ; Malekianpour, M. ; Gilbert, T. J. ; Pell, A. C. H. ; Oldroyd, K. G. / Relation between coronary derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention. In: Heart. 2004 ; Vol. 90, No. 12. pp. 1450-1454.
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    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",
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    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

    VL - 90

    SP - 1450

    EP - 1454

    JO - Heart

    JF - Heart

    SN - 1355-6037

    IS - 12

    ER -