Thermodilution-Derived Coronary Blood Flow Pattern Immediately After Coronary Intervention as a Predictor of Microcirculatory Damage and Midterm Clinical Outcomes in Patients With ST-Segment–Elevation Myocardial Infarction

• DOI: 10.1161/circinterventions.113.000505
• Publication Date: 2014-02-19T05:38:28Z
• Authors: Masashi Fukunaga; Kenichi Fujii; Daizo Kawasaki; Hisashi Sawada; Koujiro Miki; Hiroto Tamaru; Takahiro Imanaka; Toshihiro Iwasaku; Tsuyoshi Nakata; Masahiko Shibuya; Hirokuni Akahori; Motomaru Masutani; Kaoru Kobayashi; Mitsumasa Ohyanagi; Tohru Masuyama
• Keywords: Fractional Flow Reserve; Coronary circulation

Background— Despite a sufficient coronary blood flow after primary percutaneous intervention for patients with ST-segment–elevation myocardial infarction; some have poor outcome because of microcirculatory damage. This study evaluates whether the thermodilution-derived parameters immediately predict early microvascular damage and midterm outcomes in infarction. Methods Results— Using pressure sensor/thermistor-tipped guidewire, we measured index resistance at maximum hyperemia, pattern was assessed from thermodilution curves successful 88 Coronary classified into 3 groups according to shape curve: narrow unimodal (n=41), wide (n=32), or bimodal (n=15). All had contrast-enhanced cardiac magnetic resonance scans within 2 weeks. The values were significantly higher both than group (65±41 76±38 versus 20±9U; P <0.001). Bimodal prevalence obstruction on when compared other (100%, 78%, 30%; Patients risk death heart failure rehospitalization 6 months (73%, 6.3%, 7.3%; Multivariate analysis revealed that curve only independent predictor infarction ( <0.01). Conclusions— A curve, which may indicate edema consequent extrinsic compression capillary network, is associated clinical rather value itself.