Impact of Culprit Plaque Tissue and Microvascular Embolization on Reperfusion Injury and Development of Optimal Interventional Procedures

2016 Fiscal Year Final Research Report

• Project/Area Number: 26461075
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Kumamoto University
• Principal Investigator: Tsujita Kenichi 熊本大学, 大学院生命科学研究部(医), 教授 (60571263)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 冠攣縮 / 血管内超音波 / 冠動脈プラーク / 組織性状

Outline of Final Research Achievements

1. Verifying the feasibility and reproducibility of hyperemic microvascular resistance (hMR) in patients with healthy normal coronary arteries, the value of hMR was significantly correlated with the degree of the left ventricular hypertrophy (LVH), which has been considered to lead to microvascular dysfunction (MVD). Therefore, hMR value can be recognized as a reliable physiologic marker of MVD.
2. Coronary imaging study using IVUS/OCT demonstrated that unstable plaques containing the distal embolizing debris (e.g. lipidic tissue and necrotic　tissue) was more frequently observed in patients with ST-elevation myocardial infarction (STEMI) than in patients with non-ST-elevation MI. As the patients with STEMI experience the reperfusion injury (RI) frequently, distal embolization of culprit plaque component seems to be main reason of RI onset.
3. Thrombus aspiration was associated with reduced incidence of no reflow and slow flow during the pPCI and with the lower hMR.

Free Research Field

医歯薬学