title: Inflection point of ascending aortic waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty.
abstract: BACKGROUND
  Although it was reported that the pulsatility of ascending aortic pressure is closely related to restenosis after percutaneous transluminal coronary angioplasty (PTCA), it is not known whether the reflection period of ascending aortic pressure can predict restenosis after PTCA. The purpose of this study was to evaluate whether reflection in the arterial system can be used to predict restenosis after PTCA.
  
  
  METHODS
  We used the inflection point as the reflection period index and measured the coronary artery diameter, aortic pressure, and inflection time before PTCA. We defined the inflection time as the time interval from the initiation of systolic pressure waveform to the inflection point. We prospectively investigated the effect of inflection time in relation to the subsequent risk of restenosis after PTCA in patients with coronary artery disease.
  
  
  RESULTS
  Crude cumulative incidence rates of restenosis were 74.1% for the lowest, 33.3% for the middle, and 26.1% for the highest tertile of inflection point levels. After adjustments for age, gender, smoking habits, hypertension, type 2 diabetes, hypercholesterolemia, old myocardial infarction, vessel location, post-minimal lumen diameter, heart rate, and ejection fraction, the odds ratio of restenosis was 6.99 (95% confidence interval, 1.54 to 31.7) for the lowest tertile of the inflection time level compared with the highest tertile level.
  
  
  CONCLUSIONS
  Inflection time is a powerful predictor of restenosis after PTCA.
authors.affiliation: Department of Cardiology, Ishikiriseiki Hospital, Higashiosaka-City, Osaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ueda
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Kei
authors.initials: K
authors.lastname: Tsumura
authors.forename: Kiyomichi
authors.initials: K
authors.lastname: Yoshimaru
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001011:Aorta / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology*; D012307:Risk Factors