title: The influence of elective percutaneous coronary intervention on microvascular resistance: a serial assessment using the index of microcirculatory resistance.
abstract: This study investigates whether hyperemic microvascular resistance (MR) is influenced by elective percutaneous coronary intervention (PCI) by using the index of microcirculatory resistance (IMR). Seventy-one consecutive patients with stable angina pectoris undergoing elective PCI were prospectively studied. The IMR was measured before and after PCI and at the 10-mo follow-up. The IMR significantly decreased until follow-up; the pre-PCI, post-PCI, and follow-up IMRs had a median of 19.8 (interquartile range, 14.6-28.9), 16.2 (11.8-22.1), and 14.8 (11.8-18.7), respectively (P < 0.001). The pre-PCI IMR was significantly correlated with the change in IMR between pre- and post-PCI (r = 0.84, P < 0.001) and between pre-PCI and follow-up (r = 0.93, P < 0.001). Pre-PCI IMR values were significantly higher in territories with decreases in IMR than in those with increases in IMR [pre-PCI IMR: 25.4 (18.4-35.5) vs. 12.5 (9.4-16.8), P < 0.001]. At follow-up, IMR values in territories showing decreases in IMR were significantly lower than those with increases in IMR [IMR at follow-up: 13.9 (10.9-17.6) vs. 16.6 (14.0-21.4), P = 0.013]. The IMR decrease was significantly associated with a greater shortening of mean transit time, indicating increases in coronary flow (P < 0.001). The optimal cut-off values of pre-PCI IMR to predict a decrease in IMR after PCI and at follow-up were 16.8 and 17.0, respectively. In conclusion, elective PCI affected hyperemic MR and its change was associated with pre-PCI MR, resulting in showing a wide distribution. Overall hyperemic MR significantly decreased until follow-up. The modified hyperemic MR introduced by PCI may affect post-PCI coronary flow.
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Murai
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Tetsumin
authors.initials: T
authors.lastname: Lee
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kanaji
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Junji
authors.initials: J
authors.lastname: Matsuda
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Usui
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Makoto
authors.initials: M
authors.lastname: Araki
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Niida
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hishikari
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Sadamitsu
authors.initials: S
authors.lastname: Ichijyo
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Rikuta
authors.initials: R
authors.lastname: Hamaya
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and.
authors.forename: Taishi
authors.initials: T
authors.lastname: Yonetsu
authors.affiliation: Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.affiliation: Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan; and kaz@joy.email.ne.jp.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Kakuta
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D003326:Coronary Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000502:physiology*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008833:Microcirculation / Q000502:physiology; D055806:Microvessels / Q000502:physiology*; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000502:physiology*
keywords: coronary artery disease; fractional flow reserve; index of microcirculatory resistance; microvascular resistance; percutaneous coronary intervention