| Project/Area Number |
13670766
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | KAWASAKI MEDICAL SCHOOL |
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Principal Investigator |
AKASAKA Takashi KAWASAKI MEDICAL SCHOOL, CARDIOLOGY, ASSOCIATE PROFESSOR, 医学部, 助教授 (70322584)
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| Co-Investigator(Kenkyū-buntansha) |
YADA Toyotaka KAWASAKI MEDICAL SCHOOL, MEDICAL ENGINEERING, ASSISTANT, 医学部, 講師 (00210279)
YOSHIDA Kiyoshi KAWASAKI MEDICAL SCHOOL, CARDIOLOGY, PROFESSOR, 医学部, 教授 (60322583)
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| Project Period (FY) |
2001 – 2002
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| Project Status |
Completed (Fiscal Year 2002)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2002: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 2001: ¥2,300,000 (Direct Cost: ¥2,300,000)
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| Keywords | CORONARY CIRCULATION / ISCHEMIC HEART DISEASE / CORONARY ARTERY STENOSIS / INTRACORONARY ARTERY PRESSURE |
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| Research Abstract |
Physiological assessment of cornary artery stenosis severity be very important in decision making of patient care in daily clinical practice. This study was aimed to investigato whether the slope index of instantaneous diastolic hypermic proximal to distal pressure relation across the stenosis (SIDHPDPR) would represent the degree of stenosis physiologically, and whether this index would be useful in the diagnosis of coronary artery stenosis severity. Proximal and distal coronary artery pressure across the various degree of stenoses were measured instantaneously during hyperemia in open- chest anesthetized dogs, and SIDHPDPRs were obtained using off- line computer analysis. Pressure- derived myocardial fractional flow reserve (FFR), which was thought to be a phisiological index of coronary artery stenosis, was obtained by the ratio of distal and proximal coronary pressure across the stenosis during hyperemia. Those indexes were compared with the anatomical stenosis severity (percent diameter stenosis; %DS) assessed by quantitative coronary angiography. Similar assessment was also performed in angina patients during cardiac catheterization. Significant correlations were observed between %DS (x) and SIDHPDPR (y) in both animal experimental study and human study (y=0.03x + 0.7_yr=0.93, p<0.001, y=0.04x + 0.5, r=0.006x; 0.96, r-0.80, p<0.001), these correlations were affected by the drifts of proximal and/or distal pressure. In cases with microvascular dysfunction such as diabetes mellitus or old myocardial infarction, SIDHPDPRs and FFRs tended to underestimate the degree of stenosis. Thus, SIDHPDPR was thoughted to be a better index for physiological assessment of coronary artery stenosis severity compared with FFR
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