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Coronary microvascular dysfunction after elective percutaneous coronary intervention: correlation with exercise stress test results.
- Source :
-
International journal of cardiology [Int J Cardiol] 2013 Sep 20; Vol. 168 (1), pp. 121-5. Date of Electronic Publication: 2012 Oct 08. - Publication Year :
- 2013
-
Abstract
- Objectives: We assessed whether exercise stress test (EST) results are related to the presence of coronary microvascular dysfunction (CMVD) in patients undergoing elective percutaneous coronary intervention (PCI).<br />Background: Previous studies showed that EST is poorly reliable in predicting restenosis after PCI; some studies also showed CMVD in the territory of the treated vessel.<br />Methods: We studied 29 patients (age 64 ± 6, 23 M) with stable coronary artery disease and isolated stenosis (>75%) of the left anterior descending (LAD) coronary artery, undergoing successful PCI with stent implantation. EST and assessment of coronary microvascular function were performed 24h, 3 months and 6 months after PCI. Coronary blood flow (CBF) response to adenosine and to cold-pressor test (CPT) was assessed in the LAD coronary artery by transthoracic Doppler echocardiography.<br />Results: Patients with ST-segment depression ≥ 1 mm at EST performed 24h after PCI (n=11, 38%) showed a lower CBF response to adenosine compared to those with negative EST (1.65 ± 0.4 vs. 2.11 ± 0.4, respectively, p=0.003), whereas the difference in CBF response to CPT was not significant (1.44 ± 0.4 vs. 1.64 ± 0.3, respectively; p=0.11). At 3-month and 6-month follow-up a positive EST was found in 12 (41%) and 13 (44%) patients, respectively; patients with positive EST also had lower CBF response to adenosine compared to those with negative EST (3 months: 1.69 ± 0.3 vs. 2.20 ± 0.3, respectively; 6 months: 1.66 ± 0.2 vs. 2.32 ± 0.3, respectively; p<0.001 for both).<br />Conclusions: Positive EST after elective successful PCI consistently reflects impairment of hyperemic CBF due to CMVD, which persists over a follow-up period of 6 months.<br /> (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Aged
Blood Flow Velocity physiology
Coronary Artery Disease diagnosis
Coronary Artery Disease physiopathology
Elective Surgical Procedures trends
Exercise Test trends
Female
Follow-Up Studies
Humans
Male
Middle Aged
Percutaneous Coronary Intervention trends
Coronary Artery Disease surgery
Coronary Circulation physiology
Elective Surgical Procedures adverse effects
Exercise Test methods
Microvessels physiopathology
Percutaneous Coronary Intervention adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 168
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 23058352
- Full Text :
- https://doi.org/10.1016/j.ijcard.2012.09.059