The Effects of Coronary Artery Remodeling on the Developments of Collateral Blood Flow in Patients with Acute Myocardial Infarction Treated with Primary Angioplasty

Abstract

Background: The relation between pressure-derived fractional collateral flow (PDCF) and coronary arterial remodeling remains uncertain in acute myocardial infarction. Methods: We evaluated the effect of arterial remodeling on the development of PDCF in 72 patients with first acute myocardial infarction (pain onset 1.0 and nonpositive remodeling as a RI ≤1.0. Using a 0.014-in. fiber optic pressure moni- toring guide wire, the PDCF index was measured by simultaneous measurement of mean aorta pressure (Pao), distal coronary pressure during the balloon occlusion (Pocc), and central venous pressure (CVP): PDCF index= 100×(Pocc-CVP)/(Pao-CVP). Sufficient collateral was defined as PDCF index >24% and insufficient collateral as PDCF index ≤24%. Results: The RI was 1.04±0.15 in the lesions with sufficient collateral and 1.03±0.16 in the lesions with insufficient collateral (p=0.812). There was no significant difference in the frequency of positive remodeling between the 2 groups (55% vs. 54%, respectively, p=0.966). The PDCF index was 20±11% and 20± 9% in positive and nonpositive remodeling, respectively (p=0.891). There was no significant correlation between RI and PDCF index (r=0.027, p=0.823). Conclusions: The pattern of coronary arterial remodeling might not influence the development of collateral blood flow in patients with acute myocardial infarction treated with primary