Influence Of Percutaneous Coronary Intervention Research Articles

Early effect of percutaneous coronary intervention of non-left anterior descending artery on coronary flow velocity reserve of left anterior descending artery assessed by transthoracic Doppler echocardiography.

BackgroundLimited data are available regarding the influence of percutaneous coronary intervention (PCI) of non-totally occluded lesions (non-CTO) on the coronary flow of non-target vessels. We sought to investigate the short-term impact of the non-left anterior descending artery (non-LAD) PCI on the coronary flow physiology of LAD using transthoracic Doppler echocardiography (TDE).Methods and resultsWe consecutively studied 50 patients who underwent successful PCI of non-LAD and non-CTO lesions and a coronary flow velocity assessment of LAD at rest and maximal hyperemia before and at 2 days after the procedure by TDE. Coronary flow velocity reserve (CFVR) was calculated as the ratio of hyperemic to resting diastolic peak velocity (hDPV/bDPV). We evaluated the changes in LAD coronary flow characteristics after PCI of non-LAD and explored the determinants of the change in LAD-CFVR. The median fractional flow reserve (FFR) of the culprit lesion and the LAD quantitative flow ratio (QFR) were 0.67 and 0.88, respectively. After non-LAD PCI, LAD-CFVR was decreased in 33 patients (66.0%). LAD-CFVR significantly decreased (pre-PCI: 2.41, post-PCI: 2.03, p = 0.001) due to a significant decrease in LAD-hDPV (P = 0.007). The prevalence of impaired LAD-CFVR (≤2.0) significantly increased (pre: 30%, post: 48%, P = 0.027). Multivariable linear regression analysis showed that pre-PCI LAD-CFVR was independent predictor of the change in LAD-CFVR after PCI.ConclusionsLAD-CFVR significantly decreased after successful non-LAD PCI due to the postprocedural reduction of coronary flow assessed by LAD-hDPV.

Influence of percutaneous coronary intervention on T-wave peak-end interval in coronary heart disease patients and its warning value on sudden cardiac death

Objective To investigate the influence of percutaneous coronary intervention on T-wave peak-to-interval and its value of early warning of sudden cardiac death in patients with coronary artery disease. Methods From January 2013 to December 2014, 90 patients with coronary heart disease who underwent percutaneous coronary intervention in the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine were selected as observation group.And at the same time, 90 patients with normal coronary angiography in our hospital were selected as control group.Tp-Te (T-wave peak to end-time limit in ECG) and Tp-Te/QT (Tp-Te) were compared between the observation group and the control group.The ratio of the period to the QT interval, Tp-Te/ (heart rate corrected T-peak period), Tp-Te, Tp-Te/QT, Tp-Te/ before and after treatment in the observation group, and treatment Tp-Te, Tp-Te/QT, Tp-Te/ in the group with and without ventricular arrhythmia and sudden cardiac death were observed. Results Before treatment, the Tp-Te[(116.47±26.81)ms], Tp-Te/QT[(0.29±0.06)] and Tp-Te/[(131.78±36.23)ms] in the observation group were higher than those in the control group -Te(78.69±22.73)ms, Tp-Te/QT (0.21±0.04), Tp-Te/ (100.49±32.96)ms] (t=10.197, 10.525, 6.061, all P<0.05). After treatment, the Tp-Te[(94.78±11.34)ms], Tp-Te/QT[(0.24±0.04)], Tp-Te/[(108.62±20.18)ms] in the observation group were lower than those before treatment (t=7.069, 6.558, 5.298, all P<0.05). At 6 months after operation, the Tp-Te and Tp-Te/ were significantly lower than postoperative 24h[(99.89±21.64)ms, (117.35±32.47)ms](t=1.984, 2.166, all P<0.05). After treatment, the Tp-Te[(118.87±30.92)ms], Tp-Te/QT [(0.29±0.08)], and Tp-Te/[(135.73±37.29)ms] in ventricular arrhythmia patients with sudden cardiac death were higher than those without sudden cardiac death[(95.13±26.38)ms, (0.25±0.06), (106.36±30.14)ms] (t=3.012, 2.171, 3.226, all P<0.05). Conclusion T-Te, Tp-Te/QT, Tp-Te/ T-peak peak-to-interphase indicators can be used to predict the degree of coronary artery ischemia and disease, but also for cardiovascular diseases such as ventricular arrhythmias and sudden cardiac death.The index adverse events play a certain role in early warning and have clinical research value. Key words: Percutaneous coronary intervention; Coronary disease; T-wave peak end-stage

Application of stress-only myocardial perfusion imaging.

Single-photon emission computed tomography myocardial perfusion study is usually a sequence of stress and rest part. In case of a normal stress study rest part can be given up. The objective of this study was to examine factors affecting concordance of results of stress-only (SO) and stress-rest (SR) studies. SO and SR studies without and with attenuation correction (AC) of 212 selected patients (without cardiomyopathy, history of myocardial infarction or coronary artery bypass grafting) were analyzed visually. Influence of percutaneous coronary intervention (PCI) in the past, type of stress (physical/pharmacological) and application of AC (in form of combined method of non-corrected and corrected images - CM), patient body mass index (BMI) and gender on concordance rates of SO and SR studies were examined. Neither a history of PCI, nor a type of stress affected concordance rate. AC (in form of CM) improved concordance rate significantly, from 60% to 68% (p = 0.018). Patient BMI affected concordance rates - 72% in non-obese and 59% in obese patients (p = 0.05). In the whole group, risk of overlooking patients with abnormal perfusion in SO study was small (< 2%), but it grew significantly with patient BMI. Rest study was necessary in about 20% of non-obese and in about 50% of obese patients. MPS can be limited to stress part in appropriately selected, especially non-obese, patients provided that AC is applied, due to a low risk of overlooking patients with abnormal perfusion. In case of obese patients, careful analysis of exercise images for their normality is particularly important.

Influence of percutaneous coronary intervention on homocysteine and galection-3 in serum of patients with coronary heart disease and correlation analysis

Objective To discuss the influence of percutaneous coronary intervention(PCI) on the serum concentration of homocysteine(Hcy) and galectin-3 in patients with coronary heart disease(CHD). Methods From September 2016 to October 2017, 70 patients in Ji'nan Central Hospital were selected.According to the results of coronary angiography(CAG), they were divided into observation group with drug-eluted stents(n=47, including 25 cases with type A CHD and 22 cases with type B CHD) and control group without abnormal CAG(n=23). Serial venous blood samples were obtained 1 day before PCI as well as 1 day and 7 days after PCI.Plasma concentrations of Hcy, BNP and galectin-3 were measured and compared.The postoperative patients with PCI were tracked for 1 year to observe the influence of serum Hcy and galectin-3 on the severity of CHD and the quality after PCI. Results The plasma Hcy levels of type A[(16.52±5.41)μmol/L]and type B[(19.32±6.35)μmol/L]after PCI were significantly higher than those of the type A[(11.66±3.25)μmol/L]and the type B[(15.87±5.20)μmol/L]before PCI(t=2.375, P<0.05, t=2.97, P<0.01). Meanwhile, the plasma galectin-3 levels of type A[(0.86±0.11)μg/L] and type B[(1.15±0.48)μg/L]after PCI were also higher than those of the type A[(0.32±0.53)μg/L]and the type B[(0.46±0.19)μg/L]before PCI(t=2.178, P<0.05, t=4.269, P<0.01). Furthermore, levels of the plasma Hcy and galectin-3 were positively associated with the severity of CHD. Conclusion The higher blood levels of serum Hcy, BNP and galectin-3 after PCI indicate that the balloon inflation and implantation of stent can affect the level of plasma Hcy, BNP and galectin-3.Therefore, the levels of serum Hcy and galectin-3 are helpful to diagnose CHD and evaluate the degree of CHD. Key words: Coronary artery disease; Percutaneous coronary intervention; Cysteine; Brain natriuretic peptide; Galectin-3; Coronary angiography; Serum; Degree of the lesion

GW29-e0539 The Influence of Percutaneous Coronary Intervention On The Prognosis of chronic coronary artery disease Patients Implanted With ICD/CRT-D

GW29-e0539 The Influence of Percutaneous Coronary Intervention On The Prognosis of chronic coronary artery disease Patients Implanted With ICD/CRT-D

Effects of Percutaneous Coronary Intervention on Serum Angiopoietin-2 in Patients with Coronary Heart Disease.

Background:Angiopoietin-2 (Ang-2) plays a crucial role in hypoxia-induced angiogenesis and is expressed only in sites of vascular remodeling. Ang-2 expression can be regulated by hypoxia inducible factors and other regulators with exposure to hypoxia. The objective of this study was to investigate the influence of percutaneous coronary intervention (PCI) on serum Ang-2 concentrations, and analyze the correlation between serum Ang-2 and the severity of coronary artery stenosis in patients with coronary heart disease (CHD).Methods:Sixty-four patients with CHD were selected as the study group, each undergone PCI. Thirty-two healthy subjects were selected as the control group. Pre-PCI and post-PCI serum Ang-2 were measured by enzyme-linked immunosorbent assay. The severity of coronary artery stenosis was evaluated using angiographic Gensini scores, and the coronary collateral vessels were scored according to Rentrop's classification.Results:Concentrations of pre-PCI serum Ang-2 in the study group were significantly higher than those in the control group (4625.06 ± 1838.06 vs. 1945.74 ± 1588.17 pg/ml, P < 0.01); however, concentrations of post-PCI serum Ang-2 were significantly lower than those of pre-PCI (3042.63 ± 1845.33 pg/ml vs. 4625.06 ± 1838.06 pg/ml, P < 0.01). Concentrations of pre-PCI serum Ang-2 were significantly correlated with Gensini scores (r = 0.488, P < 0.01); however, the decrease in serum Ang-2 after PCI was not correlated with Gensini scores, coronary collateral vessel grading, or left ventricular ejection fraction.Conclusions:Serum Ang-2 concentrations significantly increased in patients with CHD, and PCI treatment significantly decreased these concentrations. Serum Ang-2 concentrations, but not the decrease in serum Ang-2 concentrations, were significantly correlated with the severity of coronary artery stenosis. These results suggested that Ang-2 may be a biomarker of myocardial ischemia and vessel remodeling.

Long-Term Prognosis Following Resuscitation From Out of Hospital Cardiac Arrest: Role of Percutaneous Coronary Intervention and Therapeutic Hypothermia

The aim of the study was to assess the influence of percutaneous coronary intervention (PCI) and therapeutic hypothermia (TH) on long-term prognosis. Although hospital care consisting of TH and/or PCI in particular patients resuscitated following out-of-hospital cardiac arrest (OHCA) can improve survival to hospital discharge, there is little evidence regarding how these therapies may impact long-term prognosis. We performed a cohort investigation of all persons >18 years of age who suffered nontraumatic OHCA and were resuscitated and discharged alive from the hospital between January 1, 2001, and December 31, 2009, in a metropolitan emergency medical service (EMS) system. We reviewed EMS and hospital records, state death certificates, and the national death index to determine clinical characteristics and vital status. Survival analyses were conducted using Kaplan-Meier estimates and multivariable Cox regression. Analyses of TH were restricted to those patients who were comatose at hospital admission. Of the 5,958 persons who received EMS-attempted resuscitation, 1,001 (16.8%) were discharged alive from the hospital. PCI was performed in 384 of 1,001 (38.4%), whereas TH was performed in 241 of 941 (25.6%) persons comatose at hospital admission. Five-year survival was 78.7% among those treated with PCI compared with 54.4% among those not receiving PCI and 77.5% among those treated with TH compared with 60.4% among those not receiving TH (both p < 0.001). After adjustment for confounders, PCI was associated with a lower risk of death (hazard ratio [HR]: 0.46 [95% confidence interval [CI]: 0.34 to 0.61]; p < 0.001). Likewise, TH was associated with a lower risk of death (HR: 0.70 [95% CI: 0.50 to 0.97]; p = 0.04). The findings suggested that effects of acute hospital interventions for post-resuscitation treatment extend beyond hospital survival and can positively influence prognosis following the arrest hospitalization.

Increased circulating placental growth factor during percutaneous coronary intervention is associated with applied radiocontrast agent

Recent studies have suggested placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) as promising new biomarkers for risk stratification in acute coronary syndromes (ACS). However, little is known about the influence of percutaneous coronary intervention (PCI) on circulating PlGF and VEGF levels. Thirty-five patients with ACS, 27 patients with stable coronary artery disease (sCAD), and nine healthy controls were enrolled in the study. Although all patients with ACS and 14 patients with stable angina pectoris underwent PCI, 13 patients with coronary artery disease required no revascularization (sCAD). PlGF and VEGF plasma concentrations were measured by immunoassay during and at the end of PCI and coronary angiography. Plasma PlGF levels were comparable in patients with ACS and sCAD on admission. Although coronary angiography or heparin alone did not alter PlGF and VEGF levels, immediately after PCI a dramatic increase was seen in circulating PlGF and a decrease in VEGF, which was independent of the clinical presentation of the patients, heparin administration, or the angiographic procedure itself, but was associated with the extent of coronary artery disease and the amount of the injected contrast media. In-vitro experiments revealed that radiocontrast agents induced the release of PlGF from endothelial cells without altering PlGF mRNA expression. Patients undergoing PCI exhibit an increase in circulating PlGF, probably caused by posttranslational modifications of radiocontrast agents in endothelial cells. Therefore, analysis of plasma PlGF and VEGF levels may consider the timing of blood sampling with respect to PCI and contrast media exposure.

Influence of Percutaneous Coronary Intervention on Coronary Microvascular Resistance Index

Coronary microvascular resistance during maximal hyperemia is generally assumed to be unaffected by percutaneous coronary interventions (PCIs). We assessed a velocity-based index of hyperemic microvascular resistance (h-MR(v)) by using prototypes of a novel, dual-sensor (Doppler velocity and pressure)-equipped guidewire before and after PCI to test this hypothesis. Aortic pressure, flow velocity (h-v), and pressure (h-P(d)) distal to 24 coronary lesions were measured simultaneously during maximal hyperemia induced by intracoronary adenosine. Measurements were obtained in the reference vessel before PCI and in the target vessel before and after PCI, stenting, and ultrasound-guided, upsized stenting. h-P(d) increased from 57.9+/-17.0 to 85.5+/-15.6 mm Hg, and h-MR(v) (ie, h-P(d)/h-v) decreased from 2.74+/-1.40 to 1.58+/-0.61 mm Hg x cm(-1) . s after stenting (both P<0.001). The reduction in h-MR(v) accounted for 34% of the decrease in total coronary resistance achieved by PCI. h-MR(v) of the target vessel after PCI was lower than that of the corresponding reference vessel despite a higher h-P(d) in the reference vessel (P<0.01). Post-PCI baseline MR(v) was correlated with baseline P(d) before PCI (P<0.01). PCI-induced restoration of P(d) resulted in a reduction of h-MR(v) in accordance with the pressure dependence of h-MR(v). The decrease in h-MR(v) to a level below that of the corresponding reference vessel in the immediate post-PCI period and a lowered baseline MR(v) suggest microvascular remodeling induced by long-term exposure to a low-pressure environment.