Thermodilutional Confirmation of Coronary Microvascular Dysfunction in Patients With Recurrent Angina After Successful Percutaneous Coronary Intervention

2015 ◽  
Vol 31 (8) ◽  
pp. 989-997 ◽  
Author(s):  
Yi Li ◽  
Daya Yang ◽  
Lihe Lu ◽  
Dexi Wu ◽  
Jianping Yao ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Microvascular Dysfunction ◽  
Coronary Intervention ◽  
Coronary Microvascular Dysfunction ◽  
Recurrent Angina ◽  
Percutaneous Coronary

scholarly journals Severe obstructive sleep apnea is associated with coronary microvascular dysfunction and obstruction in patients with ST-elevation myocardial infarction

2020 ◽  
pp. 204887262091994
Author(s):  
Yoshitaka Ichikawa ◽  
Yasuhiro Izumiya ◽  
Koichi Tamita ◽  
Hiroya Hayashi ◽  
Hirotoshi Ishikawa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Microvascular Obstruction ◽  
Microvascular Dysfunction ◽  
Coronary Intervention ◽  
Magnetic Resonance Images ◽  
Coronary Microvascular Dysfunction ◽  
Obstructive Sleep ◽  
Percutaneous Coronary

Background Coronary microvascular dysfunction and obstruction (CMVO) is a strong predictor of a poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Although research has suggested that obstructive sleep apnea (OSA) exacerbates CMVO after primary percutaneous coronary intervention, data supporting a correlation between OSA and CMVO are limited. This study was performed to investigate whether OSA is associated with CMVO, detected as microvascular obstruction on cardiovascular magnetic resonance images, in patients with STEMI. Methods Patients ( N = 249) with a first STEMI underwent primary percutaneous coronary intervention. CMVO was evaluated on cardiovascular magnetic resonance images based on the presence of microvascular obstruction. OSA was classified into four levels of severity based on the respiratory event index (REI): absent (REI of <5), mild (REI of ≥5 to <15), moderate (REI of ≥15 to <30) and severe (REI of ≥30). Results The REI was significantly higher in the presence of microvascular obstruction ( n = 139) than in its absence ( n = 110) (REI of 12.8 vs. 10.7, respectively; p = 0.023). Microvascular obstruction was observed in 42%, 58%, 57% and 70% of patients in the absent, mild, moderate and severe OSA groups, respectively. Multiple logistic regression analysis showed that severe OSA was associated with increased odds of microvascular obstruction (odds ratio (OR), 5.10; 95% confidence interval (CI),1.61–16.2; p = 0.006). Mild and moderate OSA were also associated with increased odds of microvascular obstruction (mild OSA: OR, 2.88; 95% CI, 1.19–7.00; p = 0.019 and moderate OSA: OR, 3.79; 95% CI, 1.43–10.1; p = 0.008). Conclusion Severe OSA was associated with CMVO after primary percutaneous coronary intervention in patients with STEMI.

scholarly journals Relationship between the ST-Segment Resolution and Microvascular Dysfunction in Patients Who Underwent Primary Percutaneous Coronary Intervention

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Byung Gyu Kim ◽  
Sung Woo Cho ◽  
Jeong-Ha Ha ◽  
Hyo Seung Ahn ◽  
Hye Young Lee ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Microvascular Dysfunction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary

Objectives. Incomplete ST-segment elevation resolution (STR) occasionally occurs despite successful revascularization of epicardial coronary artery after primary percutaneous coronary intervention (PPCI). The aim of this study was to evaluate the relationship between the degree of STR and the severity of microvascular dysfunction. Methods. A total of 73 consecutive patients with ST-segment elevation myocardial infarction (STEMI) who underwent successful PPCI were evaluated. Serial 12-lead electrocardiography was performed at baseline and at 90 minutes after PPCI. Microvascular dysfunction was assessed by index of microvascular resistance (IMR) immediately after PPCI. Results. Patients were classified into 2 groups: 50 patients with complete STR (STR ≥50%) and 23 patients with incomplete STR (STR <50%). The incomplete STR group had a higher IMR value and lower left ventricular ejection fraction (LVEF), compared with the complete STR group. The degree of STR was significantly correlated with IMR (r = −0.416, P=0.002) and LVEF (r = 0.300, P=0.011). These correlations were only observed in patients with left anterior descending artery (LAD) infarction but not observed in patients with non-LAD infarction. A cutoff IMR value was 27.3 for predicting incomplete STR after PPCI. Conclusion. Incomplete STR after PPCI in patients with STEMI reflects the presence of microvascular and left ventricular dysfunction, especially in patients with LAD infarction.

scholarly journals Outcome of Primary Percutaneous Coronary Intervention in Ibrahim Cardiac Hospital & Research Institute

2015 ◽  
Vol 3 (1-2) ◽  
pp. 10-14
Author(s):  
Syed Dawood Md Taimur ◽  
CM Shaheen Kabir ◽  
M Maksumul Haq ◽  
Md Rezaul Karim ◽  
Md Saidur Rahman Khan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Primary Pci ◽  
Recurrent Angina ◽  
Percutaneous Coronary ◽  
Research Institute

Objective: To determine the outcome of primary percutaneous coronary intervention (PPCI) in Ibrahim Cardiac Hospital & Research Institute. Methods: Medical records of 66 consecutive patients presented in our hospital between January 2010 toJune,2011 with acute ST elevation myocardial infarction (STEMI) and were treated with primary PCI as a mode of reperfusion were reviewed. The primary end point was in hospital mortality and secondary end points were 30 day mortality, myocardial infarction, recurrent angina and congestive cardiac failure, from discharge to one month follow up. Results: The procedural success was 98.5%. One (1.5%) patient died during hospital stay .No mortality was observed in the 30 days follow up from discharge while other complications like recurrent angina and acute left ventricular failure were 1.5%. Conclusions: Our findings suggest favorable outcomes, matching the international data can be achieved in our patients with primary PCI in the management of life threatening illness like STEMI despite all the limitations. Primary PCI as a preferred method of reperfusion strategy needs to be practiced more often in our part of the world. Ibrahim Cardiac Med J 2013; 3(1&2): 10-14

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