Is the residual translesional pressure gradient useful to predict regional myocardial perfusion after percutaneous transluminal coronary angioplasty?

Hugh C. MacIsaac, Merril L. Knudtson, Vincent Jb Robinson, Dante E. Manyari

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Routine assessment of the severity of a coronary artery lesion with coronary cineangiography is limited by its variability and poor correlation with blood flow and postmortem findings. In this investigation, we compared the usefulness of the final coronary artery transiesional pressure gradient and the final angiographic coronary percent stenosis to assess immediate percutaneous transluminal coronary angioplasty (PTCA) success. To accomplish this, pressure gradients and percent stenoses were compared to stress thallium-201 regional myocardial perfusion before and after 56 uncomplicated PTCAs in 51 patients with single-vessel coronary artery disease. There were 39 men and 12 women; their mean age was 59 ± 12 years. No patient had evidence of myocardial infarction. A new quantitative method to assess regional myocardial perfusion was used. Patients exercised for 433 ± 130 seconds before PTCA and for 545 ± 126 seconds after PTCA (p < 0.001). Group coronary stenosis and translesional pressure gradient decreased from 77 ± 11% and 48 ± 5 mm Hg, respectively, before PTCA, to 25 ± 11% and 9 ± 5 mm Hg, respectively, after PTCA (p < 0.001). Regional myocardial perfusion in the segment of the diseased (dilated) coronary artery increased after PTCA from 77 ± 17% to 94 ± 9% (p < 0.001). Although a significant relationship was noted between regional myocardial perfusion and percent stenosis and translesional pressure gradient, a large individual scatter was present (r values lower than 0.55). We conclude that the final translesional pressure gradient during PTCA is not a better measure of immediate PTCA success than the angiographic percent stenosis.

Original languageEnglish (US)
Pages (from-to)783-790
Number of pages8
JournalAmerican Heart Journal
Volume117
Issue number4
DOIs
StatePublished - Jan 1 1989

Fingerprint

Coronary Balloon Angioplasty
Perfusion
Pressure
Pathologic Constriction
Coronary Stenosis
Coronary Artery Disease
Coronary Vessels
Cineangiography
Thallium
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Is the residual translesional pressure gradient useful to predict regional myocardial perfusion after percutaneous transluminal coronary angioplasty? / MacIsaac, Hugh C.; Knudtson, Merril L.; Robinson, Vincent Jb; Manyari, Dante E.

In: American Heart Journal, Vol. 117, No. 4, 01.01.1989, p. 783-790.

Research output: Contribution to journalArticle

@article{425100a415cf442d831db80ff8599949,
title = "Is the residual translesional pressure gradient useful to predict regional myocardial perfusion after percutaneous transluminal coronary angioplasty?",
abstract = "Routine assessment of the severity of a coronary artery lesion with coronary cineangiography is limited by its variability and poor correlation with blood flow and postmortem findings. In this investigation, we compared the usefulness of the final coronary artery transiesional pressure gradient and the final angiographic coronary percent stenosis to assess immediate percutaneous transluminal coronary angioplasty (PTCA) success. To accomplish this, pressure gradients and percent stenoses were compared to stress thallium-201 regional myocardial perfusion before and after 56 uncomplicated PTCAs in 51 patients with single-vessel coronary artery disease. There were 39 men and 12 women; their mean age was 59 ± 12 years. No patient had evidence of myocardial infarction. A new quantitative method to assess regional myocardial perfusion was used. Patients exercised for 433 ± 130 seconds before PTCA and for 545 ± 126 seconds after PTCA (p < 0.001). Group coronary stenosis and translesional pressure gradient decreased from 77 ± 11{\%} and 48 ± 5 mm Hg, respectively, before PTCA, to 25 ± 11{\%} and 9 ± 5 mm Hg, respectively, after PTCA (p < 0.001). Regional myocardial perfusion in the segment of the diseased (dilated) coronary artery increased after PTCA from 77 ± 17{\%} to 94 ± 9{\%} (p < 0.001). Although a significant relationship was noted between regional myocardial perfusion and percent stenosis and translesional pressure gradient, a large individual scatter was present (r values lower than 0.55). We conclude that the final translesional pressure gradient during PTCA is not a better measure of immediate PTCA success than the angiographic percent stenosis.",
author = "MacIsaac, {Hugh C.} and Knudtson, {Merril L.} and Robinson, {Vincent Jb} and Manyari, {Dante E.}",
year = "1989",
month = "1",
day = "1",
doi = "10.1016/0002-8703(89)90613-3",
language = "English (US)",
volume = "117",
pages = "783--790",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Is the residual translesional pressure gradient useful to predict regional myocardial perfusion after percutaneous transluminal coronary angioplasty?

AU - MacIsaac, Hugh C.

AU - Knudtson, Merril L.

AU - Robinson, Vincent Jb

AU - Manyari, Dante E.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - Routine assessment of the severity of a coronary artery lesion with coronary cineangiography is limited by its variability and poor correlation with blood flow and postmortem findings. In this investigation, we compared the usefulness of the final coronary artery transiesional pressure gradient and the final angiographic coronary percent stenosis to assess immediate percutaneous transluminal coronary angioplasty (PTCA) success. To accomplish this, pressure gradients and percent stenoses were compared to stress thallium-201 regional myocardial perfusion before and after 56 uncomplicated PTCAs in 51 patients with single-vessel coronary artery disease. There were 39 men and 12 women; their mean age was 59 ± 12 years. No patient had evidence of myocardial infarction. A new quantitative method to assess regional myocardial perfusion was used. Patients exercised for 433 ± 130 seconds before PTCA and for 545 ± 126 seconds after PTCA (p < 0.001). Group coronary stenosis and translesional pressure gradient decreased from 77 ± 11% and 48 ± 5 mm Hg, respectively, before PTCA, to 25 ± 11% and 9 ± 5 mm Hg, respectively, after PTCA (p < 0.001). Regional myocardial perfusion in the segment of the diseased (dilated) coronary artery increased after PTCA from 77 ± 17% to 94 ± 9% (p < 0.001). Although a significant relationship was noted between regional myocardial perfusion and percent stenosis and translesional pressure gradient, a large individual scatter was present (r values lower than 0.55). We conclude that the final translesional pressure gradient during PTCA is not a better measure of immediate PTCA success than the angiographic percent stenosis.

AB - Routine assessment of the severity of a coronary artery lesion with coronary cineangiography is limited by its variability and poor correlation with blood flow and postmortem findings. In this investigation, we compared the usefulness of the final coronary artery transiesional pressure gradient and the final angiographic coronary percent stenosis to assess immediate percutaneous transluminal coronary angioplasty (PTCA) success. To accomplish this, pressure gradients and percent stenoses were compared to stress thallium-201 regional myocardial perfusion before and after 56 uncomplicated PTCAs in 51 patients with single-vessel coronary artery disease. There were 39 men and 12 women; their mean age was 59 ± 12 years. No patient had evidence of myocardial infarction. A new quantitative method to assess regional myocardial perfusion was used. Patients exercised for 433 ± 130 seconds before PTCA and for 545 ± 126 seconds after PTCA (p < 0.001). Group coronary stenosis and translesional pressure gradient decreased from 77 ± 11% and 48 ± 5 mm Hg, respectively, before PTCA, to 25 ± 11% and 9 ± 5 mm Hg, respectively, after PTCA (p < 0.001). Regional myocardial perfusion in the segment of the diseased (dilated) coronary artery increased after PTCA from 77 ± 17% to 94 ± 9% (p < 0.001). Although a significant relationship was noted between regional myocardial perfusion and percent stenosis and translesional pressure gradient, a large individual scatter was present (r values lower than 0.55). We conclude that the final translesional pressure gradient during PTCA is not a better measure of immediate PTCA success than the angiographic percent stenosis.

UR - http://www.scopus.com/inward/record.url?scp=0024590062&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024590062&partnerID=8YFLogxK

U2 - 10.1016/0002-8703(89)90613-3

DO - 10.1016/0002-8703(89)90613-3

M3 - Article

VL - 117

SP - 783

EP - 790

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 4

ER -