Effects of coronary revascularization on global coronary flow reserve in stable coronary artery disease

Aikawa, Tadao; Naya, Masanao; Obara, Masahiko et al.

Cardiovascular Research, 2019, 115(1), 119-129

Permalink : https://hdl.handle.net/2115/72289

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論文情報

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アクセス権
open access
URI
https://hdl.handle.net/2115/72289
タイトル
Effects of coronary revascularization on global coronary flow reserve in stable coronary artery disease
著者
Aikawa, Tadao ; Naya, Masanao ; Obara, Masahiko ; Manabe, Osamu ; Magota, Keiichi ; Koyanagawa, Kazuhiro ; Asakawa, Naoya ; Ito, Yoichi M. ; Shiga, Tohru ; Katoh, Chietsugu ; Anzai, Toshihisa ; Tsutsui, Hiroyuki ; Murthy, Venkatesh L. ; Tamaki, Nagara
e-Rad_Researcher
20795059
著者名
Aikawa, Tadao
e-Rad_Researcher
20455637
著者名
Naya, Masanao
著者名
Obara, Masahiko
e-Rad_Researcher
40443957
著者名
Manabe, Osamu
e-Rad_Researcher
20636419
著者名
Magota, Keiichi
著者名
Koyanagawa, Kazuhiro
著者名
Asakawa, Naoya
e-Rad_Researcher
10334236
著者名
Ito, Yoichi M.
e-Rad_Researcher
80374495
著者名
Shiga, Tohru
e-Rad_Researcher
10292012
著者名
Katoh, Chietsugu
e-Rad_Researcher
60232089
著者名
Anzai, Toshihisa
e-Rad_Researcher
70264017
著者名
Tsutsui, Hiroyuki
著者名
Murthy, Venkatesh L.
e-Rad_Researcher
30171888
著者名
Tamaki, Nagara
言語
英語
キーワード
Coronary artery disease
Coronary flow reserve
Percutaneous coronary intervention
Coronary artery bypass grafting
15O-water positron emission tomography
発行日
2019-01-01
出版者
Oxford University Press
収録物名
Cardiovascular Research
巻(号)
115(1)
ページ
119-129
抄録
Aims: Coronary flow reserve (CFR) is an integrated measure of the entire coronary vasculature, and is a powerful prognostic marker in coronary artery disease (CAD). The extent to which coronary revascularization can improve CFR is unclear. This study aimed to evaluate the impact of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on CFR in patients with stable CAD. Methods and results: In a prospective, multicentre observational study, CFR was measured by 15O-water positron emission tomography as the ratio of stress to rest myocardial blood flow at baseline and 6 months after optimal medical therapy (OMT) alone, PCI, or CABG. Changes in the SYNTAX and Leaman scores were angiographically evaluated as indicators of completeness of revascularization. Follow-up was completed by 75 (25 OMT alone, 28 PCI, and 22 CABG) out of 82 patients. The median SYNTAX and Leaman scores, and baseline CFR were 14.5 [interquartile range (IQR): 8-24.5], 5.5 (IQR: 2.5-12.5), and 1.94 (IQR: 1.67-2.66), respectively. Baseline CFR was negatively correlated with the SYNTAX (ρ = -0.40, P < 0.001) and Leaman scores (ρ = -0.33, P = 0.004). Overall, only CABG was associated with a significant increase in CFR [1.67 (IQR: 1.14-1.96) vs. 1.98 (IQR: 1.60-2.39), P < 0.001]. Among patients with CFR <2.0 (n = 41), CFR significantly increased in the PCI [1.70 (IQR: 1.42-1.79) vs. 2.21 (IQR: 1.78-2.49), P = 0.002, P < 0.001 for interaction between time and CFR] and CABG groups [1.28 (IQR: 1.13-1.80) vs. 1.86 (IQR: 1.57-2.22), P < 0.001]. The reduction in SYNTAX or Leaman scores after PCI or CABG was independently associated with the percent increase in CFR after adjusting for baseline characteristics (P = 0.012 and P = 0.011, respectively). Conclusion: Coronary revascularization ameliorated reduced CFR in patients with obstructive CAD. The degree of improvement in angiographic CAD burden by revascularization was correlated with magnitude of improvement in CFR.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution-NonCommercial 4.0 International
PISSN
0008-6363
関連情報
PMID
29992275
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1093/cvr/cvy169