PMID- 17261655
OWN - NLM
STAT- MEDLINE
DCOM- 20070313
LR  - 20161124
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 115
IP  - 5
DP  - 2007 Feb 6
TI  - Detection of coronary microembolization by Doppler ultrasound in patients with 
      stable angina pectoris undergoing elective percutaneous coronary interventions.
PG  - 600-8
AB  - BACKGROUND: Intracoronary Doppler guidewires can be used for real-time detection 
      and quantification of microembolism during percutaneous coronary interventions 
      (PCIs). We investigated whether the frequency of Doppler-detected microembolism 
      is related to the incidence of myonecrosis during elective PCI. METHODS AND 
      RESULTS: The study population included 52 consecutive patients (aged 64+/-10 
      years; 36 men, 16 women) with coronary artery disease who underwent elective PCI 
      of a single-vessel stenosis. Using intracoronary Doppler ultrasound, we compared 
      the frequency of microembolism during PCI in 22 patients with periprocedural 
      non-ST-segment elevation myocardial infarctions (pNSTEMI) and 30 patients without 
      pNSTEMI. The 2 groups were comparable with regard to their clinical and 
      procedural characteristics. In the group with pNSTEMI, the total number of 
      coronary microemboli after PCI (27+/-10 versus 16+/-8, P<0.001) was higher than 
      in the group without pNSTEMI. Although high-sensitivity C-reactive protein plasma 
      levels were similar before PCI (2.9+/-2.2 versus 3.4+/-1.7 mg/L, P=NS), they were 
      higher in the group with pNSTEMI after PCI (12.6+/-10.4 versus 6.1+/-5.1 mg/L, 
      P<0.05). Microembolic count independently correlated to postprocedural cardiac 
      troponin I elevation (r=0.565, P<0.001), coronary flow velocity reserve 
      (r=-0.506, P<0.001), and baseline average peak velocity (r=0.499, P<0.001). 
      CONCLUSIONS: Patients with pNSTEMI had a significantly higher frequency of 
      coronary microembolization during PCI, and their systemic inflammatory response 
      and microvascular impairment after PCI were more pronounced. Intracoronary 
      Doppler ultrasound provides evidence that pNSTEMI in patients undergoing elective 
      PCI is caused by microembolization during the procedure.
FAU - Bahrmann, Philipp
AU  - Bahrmann P
AD  - Clinic of Internal Medicine I, Friedrich Schiller University, Erlanger Allee 101, 
      07740 Jena, Germany. philipp.bahrmann@med.uni-jena.de
FAU - Werner, Gerald S
AU  - Werner GS
FAU - Heusch, Gerd
AU  - Heusch G
FAU - Ferrari, Markus
AU  - Ferrari M
FAU - Poerner, Tudor C
AU  - Poerner TC
FAU - Voss, Andreas
AU  - Voss A
FAU - Figulla, Hans R
AU  - Figulla HR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20070129
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Aged
MH  - Angina Pectoris/complications/*diagnostic imaging/therapy
MH  - *Angioplasty, Balloon, Coronary/methods
MH  - Coronary Artery Disease/complications/diagnostic imaging/therapy
MH  - Coronary Vessels/*diagnostic imaging
MH  - Elective Surgical Procedures/methods
MH  - Embolism/complications/*diagnostic imaging/therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - *Ultrasonography, Doppler/methods
EDAT- 2007/01/31 09:00
MHDA- 2007/03/14 09:00
CRDT- 2007/01/31 09:00
PHST- 2007/01/31 09:00 [pubmed]
PHST- 2007/03/14 09:00 [medline]
PHST- 2007/01/31 09:00 [entrez]
AID - CIRCULATIONAHA.106.660779 [pii]
AID - 10.1161/CIRCULATIONAHA.106.660779 [doi]
PST - ppublish
SO  - Circulation. 2007 Feb 6;115(5):600-8. doi: 10.1161/CIRCULATIONAHA.106.660779. 
      Epub 2007 Jan 29.