Early alteration of coronary hemodynamics in late restenosis after coronary angioplasty

Tao Cheng Wu, Jaw Wen Chen, Ching Iuan Chen, Guang Yuan Mar, Nai Wei Hsu, Ying Hwa Chen, Yu An Ding, Shih Pu Wang, Mau Song Chang

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

It is not known whether changes in coronary hemodynamics may antedate the development of restenosis after percutaneous coronary transluminal angioplasty (PTCA). The purpose of this study was to evaluate the early change in coronary microvascular function in patients with late restenosis after PTCA. Coronary hemodynamics were studied in series before, immediately after, 2 weeks and 3 months after successful PTCA in 12 male patients with a single lesion of the left anterior descending coronary artery. In each patient, great cardiac venous flow (GCVF) and oxygen content were measured both at baseline and during hyperemia induced by adenosine infusion. The sequential changes of coronary hemodynamics were compared between patients with and without restenosis at 3 months after PTCA. Basic characteristics did not differ between the patients with (n = 6) and those without restenosis (n = 6). Luminal diameter stenosis (in percentage) was also similar between the two groups both before (79.2 ± 18.4% vs 83.0 ± 9.6%, p = NS) and up to 2 weeks after PTCA (25.8 ± 10.9% vs 28.5 ± 7.9%, p = NS). In patients without restenosis, basal and hyperemic GCVF was unchanged up to 2 weeks after PTCA. There was a significant increase in CFR 3 months after PTCA. In patients with restenosis, basal GCVF was significantly increased and hyperemic GCVF was unchanged immediately after PTCA. However, 2 weeks after PTCA, basal GCVF was decreased while luminal diameter was still preserved. In comparison with those without restenosis, patients with restenosis had significantly lower CFR before (1.98 ± 0.42 vs 2.69 ± 0.46, p = 0.019), immediately after (1.47 ± 0.27 vs 2.24 ± 0.47, P = 0.006) and 3 months after PTCA (1.51 ± 0.32 vs 3.40 ± 0.54, P = 0.001). In patients without restenosis, the recovery of coronary microvascular function was delayed up to 3 months after PTCA. In patients with late restenosis, basal coronary microvascular tone was altered within 2 weeks after PTCA suggesting early deterioration of coronary microvascular function before the development of angiographic restenosis.

Original languageEnglish
Pages (from-to)535-548
Number of pages14
JournalJapanese Heart Journal
Volume40
Issue number5
DOIs
Publication statusPublished - Sept 1999
Externally publishedYes

Keywords

  • Coronary flow reserve
  • Coronary microvascular function
  • Percutaneous transluminal coronary angioplasty
  • Restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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