Pressure-diameter relationship in human coronary arteries.

Details

Serval ID
serval:BIB_1296DE3B0E4C
Type
Article: article from journal or magazin.
Collection
Publications
Title
Pressure-diameter relationship in human coronary arteries.
Journal
Circulation. Cardiovascular Interventions
Author(s)
Muller O., Pyxaras S.A., Trana C., Mangiacapra F., Barbato E., Wijns W., Taylor C.A., De Bruyne B.
ISSN
1941-7632 (Electronic)
ISSN-L
1941-7640
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
5
Number
6
Pages
791-796
Language
english
Abstract
BACKGROUND: To quantify the changes in arterial dimensions after the acute changes in pressure associated with percutaneous coronary intervention (PCI).
METHODS AND RESULTS: Forty-eight patients with one angiographically moderate-to-severe stenosis were included in the study. The pressure proximal and distal to the stenosis and the arterial diameter proximal and distal to the stenosis were measured at baseline, after intracoronary nitrates, and after stent PCI. In addition, in 8 patients distal pressure and coronary diameter were assessed while graded, controlled stenoses were created in the stented segment by progressive inflation of a balloon catheter. The mean diameter of the proximal coronary segment was 2.75 ± 0.08 mm, 2.92 ± 0.08 mm (+7.4%), and 3.10 ± 0.07 mm (+14.7%) at baseline, after nitrates and after PCI, respectively (P<0.001). The mean diameter of the distal coronary segment was 2.07 ± 0.09 mm, 2.23 ± 0.09 mm (+9.7%), and 2.5±0.07 mm (+28.4%) at baseline, after nitrates and after PCI, respectively (P<0.001). The increase in distal diameter correlated significantly with the increase in distal pressure after PCI (r(2)=0.57; P<0.001). When graded stenoses were created, a decrease in diameter of 18 ± 4% was observed with a pressure drop of 43 ± 5 mm Hg.
CONCLUSIONS: The diameter of coronary arteries markedly varies with their distending pressure. After re-establishment of a normal distending pressure by stenting of severe coronary stenoses, a proportional increase in vessel diameter is observed. This should be taken into account when choosing the stent diameter and is an argument to discourage direct stenting.
Keywords
Aged, Arterial Pressure/drug effects, Cardiac Catheterization, Chi-Square Distribution, Coronary Angiography, Coronary Stenosis/physiopathology, Coronary Stenosis/radiography, Coronary Vessels/drug effects, Coronary Vessels/physiopathology, Female, Humans, Isosorbide Dinitrate/administration & dosage, Linear Models, Male, Middle Aged, Percutaneous Coronary Intervention/instrumentation, Prosthesis Design, Severity of Illness Index, Stents, Time Factors, Treatment Outcome, Vasodilator Agents/administration & dosage
Pubmed
Web of science
Open Access
Yes
Create date
16/02/2015 17:33
Last modification date
20/08/2019 12:40
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