The decrease of plaque volume during percutaneous coronary intervention has a negative impact on coronary flow in acute myocardial infarction - A major role of percutaneous coronary intervention-induced embolization
The decrease of plaque volume during percutaneous coronary intervention has a negative impact on coronary flow in acute myocardial infarction - A major role of percutaneous coronary intervention-induced embolization
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DOI：
10.1016/j.jacc.2004.04.036
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发表时间：
2004-07-21
影响因子：
24
通讯作者：
Yoshikawa, J
中科院分区：
文献类型：
--
作者：
Sato, H;Iida, H;Yoshikawa, J
本研究的目的是评价经皮冠状动脉介入治疗（PCI）过程中斑块体积的减少如何影响急性心肌梗死（AMI）患者的冠状动脉血流。然而，很少有人知道冠状动脉血流的变化，PCI后出现在响应减少斑块在processing.METHODS的研究组包括60例AMI患者接受PCI前和PCI后血管内超声（IVUS）。对所有IVUS程序进行定性条带定量分析。每隔1.0 mm测量一次外弹性膜体积（EEMV）、管腔体积（LV）和斑块体积（PV），以包括病变和病变近端和远端3.0 mm的参考节段。PCI前后PV的差异定义为斑块体积减少指数（DeltaPV）。结果60例患者PCI术后IVUS显示斑块体积均明显缩小。13例（21.7%）患者观察到不充分的再流（CTFC > 40）。回流不足患者的PV下降幅度明显大于回流患者（49.4 +/- 18.9 vs. 31.7 +/- 15.5 mm（3），p = 0.0010）。此外，DeltaPV与PCI后CTFC显著相关（r = 0.415，p = 0.0012）。结论：AMI患者PCI期间PV降低对PCI后冠状动脉血流有负面影响。所有AMI患者均可发生PCI引起的栓塞。(C)2004年，美国心脏病学会基金会。
OBJECTIVES The aim of this study was to evaluate how decreased plaque volume during percutaneous coronary intervention (PCI) affects coronary flow in patients with acute myocardial infarction (AMI).BACKGROUND Coronary flow after reperfusion therapy is a major determinant of clinical outcomes in patients with AMI. However, little is still known about the changes in coronary flow that appear after PCI in response to the decreased plaque during the procedure.METHODS The study group comprised 60 patients with AMI who underwent pre- and post-PCI intravascular ultrasound (IVUS). Qualitative band quantitative analyses were performed on all IVUS procedures. External elastic membrane volume (EEMV), lumen volume (LV), and plaque volume (PV) were measured every 1.0 mm to include the lesion and reference segments 3.0 mm proximal and distal to the lesion. The difference between pre- and post-PCI PV was defined as the index of the decrease in plaque volume (DeltaPV). The corrected TIMI frame count (CTFC) was used to evaluate coronary flow after PCI.RESULTS Plaque volume was decreased at post-PCI IVUS in all 60 patients. Inadequate reflow (CTFC > 40) was observed in 13 patients (21.7%). The decrease in PV was significantly larger in patients with inadequate reflow than in those with reflow (49.4 +/- 18.9 vs. 31.7 +/- 15.5 mm(3), p = 0.0010). Also, DeltaPV was significantly correlated with CTFC after PCI (r = 0.415, p = 0.0012).CONCLUSIONS The decrease in PV during PCI has a negative impact on coronary flow after PCI in patients with AMI. Embolization induced by PCI may occur in all patients with AMI. (C) 2004 by the American College of Cardiology Foundation.