Coronary disease & ACSCohort study
Changes in absolute coronary blood flow and myocardial resistance after percutaneous coronary intervention
- two-centre cohort
Authors' conclusion
PCI significantly reduces epicardial resistance, leading to a pronounced increase in hyperaemic flow, which can be predicted by FFR. Resting Q remained unchanged because of compensatory increases in microvascular resistance, providing direct evidence of coronary flow autoregulation in humans. The MRR was unaffected by PCI, confirming its specificity as an index of microvascular function.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI) with pre- and post-PCI physiological assessment by continuous thermodilution
- Participants
- 52 patients
- Exposure
- pre- and post-PCI physiological assessments
Main finding
As reported in the abstract
Δ
+2 [interquartile range [IQR] −9 to 21] mL/min; p=0.21
Observational data: associations, not effects.
Further findings
Resting Repi
- Δ
- −193 [IQR −400 to −59] Wood unit (WU); p<0.001
Resting Rμ
- Δ
- +267 [IQR −20 to 474] WU; p=0.002
Hyperaemic Q
- Δ
- +44 [IQR 16 to 92] mL/min; p<0.001
Hyperaemic Repi
- Δ
- −195 [IQR −379 to −82] WU; p<0.001
Hyperaemic Rμ
- Δ
- +3 [IQR −96 to 75] WU; p=0.87
Microvascular resistance reserve (MRR)
- Δ
- −0.2 [IQR −0.7 to 0.6]; p=0.301
Fractional flow reserve (FFR) association with Repi and hyperaemic Q
- Pre- and post-PCI fractional flow reserve (FFR) were strongly and inversely associated with Repi and predicted the improvement of hyperaemic Q
Original publication
Summarised from the published abstract; every number is checked against it