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Purpose: We aimed to discover clinical and angiographic predictors of microvascular dysfunction using the index of microcirculatory resistance (IMR) in patients with ST-segment elevation myocardial infarction (STEMI).

Materials and Methods: We enrolled 113 patients with STEMI (age, 56±11 years; 95 men) who underwent primary percutaneous coronary intervention (PCI). The IMR was measured with a pressure sensor/thermistor-tipped guidewire after primary PCI. The patients were divided into three groups based on IMR values: Low IMR [<18 U (12.9±2.6 U), n=38], Mid IMR [18–31 U (23.9±4.0 U), n=38], and High IMR [>31 U (48.1±17.1 U), n=37].

Results: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups. The door-to-balloon time was <90 minutes in all patients, and it was not significantly different between groups. Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001). In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008). In multivariate regression analysis, age and symptom-onset-to-balloon time were independent determinants of a high IMR (p=0.013 and p=0.003, respectively).

Conclusion: Our data suggest that age and symptom-onset-to-balloon time might be the major predictors of microvascular dysfunction in STEMI patients with a door-to-balloon time of <90 minutes.

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참고문헌 (41건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Coronary microvascular dysfunction in the clinical setting: from mystery to reality 네이버 미소장
2 Novel Index for Invasively Assessing the Coronary Microcirculation 네이버 미소장
3 Non-invasive/invasive imaging: significance and assessment of coronary microvascular dysfunction. 네이버 미소장
4 Myocardial No-Reflow in Humans 네이버 미소장
5 Relationship of TIMI Myocardial Perfusion Grade to Mortality After Administration of Thrombolytic Drugs 네이버 미소장
6 Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. 네이버 미소장
7 Long-term prognostic value of 13N-ammonia myocardial perfusion positron emission tomography added value of coronary flow reserve. 네이버 미소장
8 Predictive Value of the Index of Microcirculatory Resistance in Patients With ST-Segment Elevation Myocardial Infarction 네이버 미소장
9 The Index of Microcirculatory Resistance Measured Acutely Predicts the Extent and Severity of Myocardial Infarction in Patients With ST-Segment Elevation Myocardial Infarction 네이버 미소장
10 Index of microcirculatory resistance as predictor for microvascular functional recovery in patients with anterior myocardial infarction. 소장
11 Prognostic Value of the Index of Microcirculatory Resistance Measured After Primary Percutaneous Coronary Intervention 네이버 미소장
12 O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;127:e362-425. 미소장
13 Effects of adenosine on human coronary arterial circulation. 네이버 미소장
14 Coronary thermodilution to assess flow reserve: validation in humans. 네이버 미소장
15 Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. 네이버 미소장
16 Coronary Thermodilution to Assess Flow Reserve: Experimental Validation 네이버 미소장
17 Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. 네이버 미소장
18 Arterial aging: pathophysiological principles. 네이버 미소장
19 Prognostic Significance of Small-Artery Structure in Hypertension 네이버 미소장
20 Peripheral Pulse Pressure, Large Arteries, and Microvessels 네이버 미소장
21 Endothelial dysfunction in diabetes: from mechanisms to therapeutic targets. 네이버 미소장
22 Marciano C, Galderisi M, Gargiulo P, Acampa W, D’Amore C, Esposito R, et al. Effects of type 2 diabetes mellitus on coronary microvascular function and myocardial perfusion in patients without obstructive coronary artery disease. Eur J Nucl Med Mol Imaging 2012;39:1199-206. 미소장
23 Rathore SS, Curtis JP, Chen J, Wang Y, Nallamothu BK, Epstein AJ, et al. Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study. BMJ 2009;338:b1807. 미소장
24 Effect of Door-to-Balloon Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction 네이버 미소장
25 Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. 네이버 미소장
26 Executive summary: heart disease and stroke statistics--2013 update: a report from the American Heart Association. 네이버 미소장
27 Door-to-balloon time and mortality among patients undergoing primary PCI. 네이버 미소장
28 Coronary and myocardial angiography: angiographic assessment of both epicardial and myocardial perfusion. 네이버 미소장
29 TIMI Myocardial Perfusion Grade and ST Segment Resolution: Association With Infarct Size as Assessed by Single Photon Emission Computed Tomography Imaging 네이버 미소장
30 Usefulness of the index of microcirculatory resistance for invasively assessing myocardial viability immediately after primary angioplasty for anterior myocardial infarction 네이버 미소장
31 Peak Cardiac Troponin-T Level, Scintigraphic Myocardial Infarct Size and One-Year Prognosis in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction 네이버 미소장
32 Comparison of the Prognostic Value of Peak Creatine Kinase-MB and Troponin Levels Among Patients With Acute Myocardial Infarction: A Report from the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines 네이버 미소장
33 Effects of microvascular dysfunction on myocardial fractional flow reserve after percutaneous coronary intervention in patients with acute myocardial infarction 네이버 미소장
34 Fractional Flow Reserve for the Assessment of Nonculprit Coronary Artery Stenoses in Patients With Acute Myocardial Infarction 네이버 미소장
35 Gibson CM, Pinto D. Fractional flow reserve: a new set of lenses for the occulostenotic reflex? JACC Cardiovasc Interv 2010;3:1282-3. 미소장
36 Variability of Microcirculatory Resistance Index and Its Relationship With Fractional Flow Reserve in Patients With Intermediate Coronary Artery Lesions 네이버 미소장
37 Harjai KJ, Mehta RH, Stone GW, Boura JA, Grines L, Brodie BR, et al. Does proximal location of culprit lesion confer worse prognosis in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction? J Interv Cardiol 2006;19:285-94. 미소장
38 Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study 네이버 미소장
39 Thrombus aspiration during ST-segment elevation myocardial infarction. 네이버 미소장
40 Thrombus aspiration during primary percutaneous coronary intervention for preserving the index of microcirculatory resistance: a randomised study. 네이버 미소장
41 Glycoprotein IIb/IIIa inhibitors with or without thienopyridine pretreatment improve outcomes after primary percutaneous coronary intervention in high‐risk patients with ST elevation myocardial infarction—a meta‐regression of randomized controlled trials 네이버 미소장

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