Coronary flow reserve of the angiographically normal left anterior descending coronary artery in patients with remote coronary artery disease
| Autor: | Enrica Mariano, Francesco Romeo, Francesco Pizzuto, Paolo Emilio Puddu, Paolo Voci, Patrizia Spedicato |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Settore MED/11 - Malattie dell'Apparato Cardiovascolare Coronary Artery Disease Anterior Descending Coronary Artery Coronary Angiography Coronary artery disease Coronary Circulation Internal medicine medicine Humans In patient Prospective Studies cardiovascular diseases Myocardial infarction Aged Ultrasonography business.industry Doppler Percutaneous coronary intervention Coronary flow reserve Ultrasonography Doppler Middle Aged Blood Flow Velocity Coronary Vessels Female medicine.disease Stenosis medicine.anatomical_structure Cardiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | The American Journal of Cardiology. 94:577-582 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2004.05.019 |
| Popis: | Coronary artery disease (CAD) has been suggested to alter coronary flow reserve (CFR; the ratio between hyperemic and baseline coronary flow velocities) not only in territories supplied by stenotic arteries but also in angiographically normal, remote regions. However, few data exist regarding the left anterior descending (LAD) coronary artery as the normal index artery. The influence of remote CAD on CFR of the angiographically normal LAD was evaluated with transthoracic Doppler ultrasound to measure CFR in the LAD during 90 seconds of venous adenosine infusion (140 microg/kg/min) in 122 subjects who were assigned to 1 group; group 1 comprised 49 controls without angiographically detectable CAD, and group 2 consisted of 73 patients with an angiographically normal LAD and remote CAD. Group 2 was divided into 4 subgroups: 16 patients with previous remote percutaneous coronary intervention (group 2A); 13 patients with significant remote stenosis (group 2B); 23 patients with previous remote myocardial infarction and percutaneous coronary intervention (group 2C); and 21 patients with previous remote myocardial infarction but no percutaneous coronary intervention (group 2D). CFR in the LAD was not significantly different in groups 1 and 2 (3.08 +/- 0.61 and 3.03 +/- 0.69, respectively, p = NS). Decreased ejection fraction and increased wall motion score index in patients with remote CAD (p < 0.00001) and multivessel CAD did not affect CFR in the LAD (group 2A 3.18 +/- 0.77; group 2B 3.05 +/- 0.65; group 2C 3.07 +/- 0.79; group 2D 2.86 +/- 0.50, respectively; F = 0.63, p = NS). In conclusion, CFR of an angiographically normal LAD is preserved in patients with remote CAD, even in the presence of previous remote myocardial infarction and wall motion abnormalities. |
| Databáze: | OpenAIRE |
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