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Pressure-derived collateral flow index as a parameter of microvascular dysfunction in acute myocardial infarction

Kouichi Yamamoto, MD^*, Hiroshi Ito, MD^*,*, Katsuomi Iwakura, MD^*, Yasunori Shintani, MD^*, Tohru Masuyama, MD, Masatsugu Hori, MD, Shigeo Kawano, MD^*, Yorihiko Higashino, MD^* and Kenshi Fujii, MD^*

^* Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan
Department of Internal Medicine and Therpaeutics, Graduate School of Medicine, Osaka University, Osaka, Japan

View larger version (19K): [in a new window]   Figure 1 Comparison of pressure-derived collateral flow index (CFIp) among angiographical collateral grades. There was no difference in CFIp among collateral grades (0, 1, 2, 3; 0.28 ± 0.07, 0.27 ± 0.09, 0.27 ± 0.08, 0.23 ± 0.08, p = NS), and a correlation was not found between the two variables. Values are expressed as mean ± SD.

View larger version (33K): [in a new window]   Figure 2 Waveforms of aortic pressure (Pa) and coronary wedge pressure (Pcw) in patients with MCE reflow (A) and with MCE no-reflow (B). Although Pcw shows comparable value in diastole, Pcw was extremely higher in systole in a case of MCE no-reflow than in a case of MCE reflow.

View larger version (17K): [in a new window]   Figure 3 Comparison of peak systolic Pcw (A) and end-diastolic Pcw (B) between the patients with MCE reflow and those with MCE no-reflow. There was no difference in end-diastolic Pcw between the two groups, but peak systolic Pcw was significantly higher in patients with MCE no-reflow than in those with MCE reflow (end-diastolic pressure: 22 ± 10 vs. 18 ± 4, NS; peak systolic pressure: 59 ± 11 vs. 40 ± 13, p < 0.01). Abbreviations as in Figure 2. Values are expressed as mean ± SD.

View larger version (17K): [in a new window]   Figure 4 Correlation between RWM and CFIp (A) and Pcw/Pa (B). There was significant inverse correlation between RWM and CFIp (A). Thus, the higher CFIp is associated with the lower RWM, implying the worse functional outcomes. Significant correlation was also found between RWM and Pcw/Pa (B). This correlation coefficient seems to be better than that between CFIp and RWM. Solid circles indicate patients with MCE no-reflow, and open circles represent patients with MCE reflow. = the difference of the values at day 28 minus those at day 1. Other abbreviations are the same as before.