Peripheral Artery Tonometry Reveals Impaired Endothelial Function before Percutaneous Coronary Intervention in Patients with Periprocedural Myocardial Injury.
Peripheral Artery Tonometry Reveals Impaired Endothelial Function before Percutaneous Coronary Intervention in Patients with Periprocedural Myocardial Injury.
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外周动脉张力测定显示围手术期心肌损伤患者经皮冠状动脉介入治疗前内皮功能受损
DOI：
10.1155/2021/5598120
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发表时间：
2021
影响因子：
2.1
通讯作者：
Ge J
中科院分区：
文献类型：
--
作者：
Chen Z;Zhou Y;Yin J;Gao Q;Chen A;Xia Y;Lu D;Huang D;Qian J;Ge J
围手术期心肌损伤（PMI）是经皮冠状动脉介入治疗（PCI）最常见的并发症。PMI的微栓塞和炎症反应可导致冠状动脉微血管功能障碍（CMD），反之亦然。反应性充血指数（RHI）是一种无创性评价内皮功能和CMD的方法，可用于预测PMI。 入选了268例疑似稳定型冠状动脉疾病（CAD）并计划进行择期冠状动脉造影的患者。在血管造影术之前通过使用Endo-PAT 2000 ™装置测量RHI。进一步评估RHI、PMI和心血管事件之间的相关性。 在该队列中，189例患者（70.5%）被诊断为CAD，119例患者（44.4%）接受了药物洗脱支架（DES）植入术。冠心病组RHI较非冠心病组低（1.88 ± 0.55vs.2.02 ± 0.58，P < 0.05）。PMI组造影前RHI较低（1.75 ± 0.37 vs.1.95 ± 0.50，P < 0.05）。RHI的受试者工作特征曲线分析显示曲线下面积（AUC）为0.61，预测PMI的敏感性为62.7%，特异性为50.0%。RHI ≤ 1.81的冠心病患者支架术后复合心脏事件发生率较高（校正危险比（HR）3.31，95%可信区间（CI）1.07-10.22，P < 0.05）。 通过PAT评估RHI可能是术前预测PMI的一种有前途的方法。RHI与DES植入后长期不良心脏事件的风险增加相关。
Periprocedural myocardial injury (PMI) is a most common complication of percutaneous coronary intervention (PCI). Microembolization and inflammation underlying PMI could lead to coronary microvascular dysfunction (CMD) and vice versa. Reactive hyperemia index (RHI) assessed by peripheral artery tonometry (PAT) has been considered as a noninvasive method to assess endothelial function and CMD, which could be useful to predict PMI. 268 patients suspected with stable coronary artery disease (CAD) and scheduled for elective coronary angiography were enrolled. RHI was measured by using the Endo-PAT2000™ device before angiography. The association among RHI, PMI, and cardiovascular events was further assessed. In this cohort, 189 patients (70.5%) were diagnosed with CAD and 119 patients (44.4%) underwent drug-eluting stent (DES) implantation. Compared with patients without CAD, CAD patients had lower RHI (1.88 ± 0.55 vs. 2.02 ± 0.58, P < 0.05). Patients with PMI had a lower RHI before angiography (1.75 ± 0.37 vs. 1.95 ± 0.50, P < 0.05). Receiver operating characteristic curve analysis of RHI revealed an area under the curve (AUC) of 0.61, with a sensitivity of 62.7% and specificity of 50.0% to predict PMI. Moreover, we found that CAD patients with RHI ≤ 1.81 had a higher incidence of composite cardiac events after stenting (adjusted hazard ratio (HR) 3.31, 95% confidence interval (CI) 1.07–10.22, P < 0.05). RHI assessment through PAT could be a promising method to predict PMI before the procedure. RHI is associated with increased risk of long-term adverse cardiac events after DES implantation.
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影响因子：
5.4
作者：
Idris H;Lo S;Shugman IM;Saad Y;Hopkins AP;Mussap C;Leung D;Thomas L;Juergens CP;French JK
通讯作者：
French JK
影响因子：
11.3
作者：
Garcia-Garcia, Hector M.;McFadden, Eugene P.;Vranckx, Pascal
通讯作者：
Vranckx, Pascal
影响因子：
3.9
作者：
Vancheri F;Longo G;Vancheri S;Henein M
通讯作者：
Henein M
影响因子：
6.2
作者：
Nardone, Massimo;Miner, Steven;Edgell, Heather
通讯作者：
Edgell, Heather
影响因子：
37.8
作者：
Gregorini, L;Marco, J;Heusch, G
通讯作者：
Heusch, G