The influence of coronary plaque morphology assessed by optical coherence tomography on final microvascular function after stenting in patients with ST-elevation myocardial infarction.
The influence of coronary plaque morphology assessed by optical coherence tomography on final microvascular function after stenting in patients with ST-elevation myocardial infarction.
- 2017
Available online from MWHC library: February 2000 - present
CONCLUSION: IMR measured before stenting is independent of the appearances of the culprit coronary plaque within the infarct-related artery. IMR after stenting, and more importantly, the change in IMR after stenting, reflect the degree of distal embolization during stent implantation. OBJECTIVES: The index of microcirculatory resistance (IMR) provides a reproducible assessment of the status of coronary microvasculature in patients with ST-elevation myocardial infarction (STEMI). Frequency-domain optical coherence tomography (FD-OCT) enables detailed assessment of the morphology of coronary plaque.We sought to determine the influence of the initial culprit coronary plaque anatomy within the infarct-related artery on IMR after stenting in STEMI. PATIENTS AND METHODS: In 25 STEMI patients IMR was measured immediately before and after stent implantation. FD-OCT imaging was performed at the same time points and atherothrombotic volume (ATV) before stenting, prolapsed+floating ATV after stenting and DELTAATV was measured using three different strategies. RESULTS: There were no relationships between preprocedural IMR and FD-OCT parameters. Prestenting IMR was related only to pain to wire time (P: 0.02). Irrespective of the method adopted, the final IMR was related to prestenting ATV (p: 0.44, P: 0.03 for method I, p: 0.48, P: 0.02 for method II and p: 0.30, P: 0.06 for method III) and DELTAATV (p: 0.41, P: 0.04 for method II and p: 0.44, P: 0.03 for method III).
English
0954-6928
*Angioplasty, Balloon, Coronary/is [Instrumentation]
*Coronary Circulation
*Coronary Vessels/dg [Diagnostic Imaging]
*Microcirculation
*Plaque, Atherosclerotic
*ST Elevation Myocardial Infarction/th [Therapy]
*Stents
*Tomography, Optical Coherence
Aged
Angioplasty, Balloon, Coronary/ae [Adverse Effects]
Cardiac Catheterization
Coronary Angiography
Coronary Vessels/pa [Pathology]
Coronary Vessels/pp [Physiopathology]
Electrocardiography
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
ST Elevation Myocardial Infarction/dg [Diagnostic Imaging]
ST Elevation Myocardial Infarction/pa [Pathology]
ST Elevation Myocardial Infarction/pp [Physiopathology]
Time Factors
Treatment Outcome
Vascular Resistance
MedStar Heart & Vascular Institute
Journal Article
Available online from MWHC library: February 2000 - present
CONCLUSION: IMR measured before stenting is independent of the appearances of the culprit coronary plaque within the infarct-related artery. IMR after stenting, and more importantly, the change in IMR after stenting, reflect the degree of distal embolization during stent implantation. OBJECTIVES: The index of microcirculatory resistance (IMR) provides a reproducible assessment of the status of coronary microvasculature in patients with ST-elevation myocardial infarction (STEMI). Frequency-domain optical coherence tomography (FD-OCT) enables detailed assessment of the morphology of coronary plaque.We sought to determine the influence of the initial culprit coronary plaque anatomy within the infarct-related artery on IMR after stenting in STEMI. PATIENTS AND METHODS: In 25 STEMI patients IMR was measured immediately before and after stent implantation. FD-OCT imaging was performed at the same time points and atherothrombotic volume (ATV) before stenting, prolapsed+floating ATV after stenting and DELTAATV was measured using three different strategies. RESULTS: There were no relationships between preprocedural IMR and FD-OCT parameters. Prestenting IMR was related only to pain to wire time (P: 0.02). Irrespective of the method adopted, the final IMR was related to prestenting ATV (p: 0.44, P: 0.03 for method I, p: 0.48, P: 0.02 for method II and p: 0.30, P: 0.06 for method III) and DELTAATV (p: 0.41, P: 0.04 for method II and p: 0.44, P: 0.03 for method III).
English
0954-6928
*Angioplasty, Balloon, Coronary/is [Instrumentation]
*Coronary Circulation
*Coronary Vessels/dg [Diagnostic Imaging]
*Microcirculation
*Plaque, Atherosclerotic
*ST Elevation Myocardial Infarction/th [Therapy]
*Stents
*Tomography, Optical Coherence
Aged
Angioplasty, Balloon, Coronary/ae [Adverse Effects]
Cardiac Catheterization
Coronary Angiography
Coronary Vessels/pa [Pathology]
Coronary Vessels/pp [Physiopathology]
Electrocardiography
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
ST Elevation Myocardial Infarction/dg [Diagnostic Imaging]
ST Elevation Myocardial Infarction/pa [Pathology]
ST Elevation Myocardial Infarction/pp [Physiopathology]
Time Factors
Treatment Outcome
Vascular Resistance
MedStar Heart & Vascular Institute
Journal Article