Invasive Assessment of the Coronary Microcirculation

冠状动脉微循环的侵入性评估

• 批准号: 7176883
• 负责人: WILLIAM F FEARON
• 金额: $ 12.6万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7176883
• 关键词: Acute myocardial infarction; Angioplasty; Area; Arterial Disorder; Arteries; Cardiac; Cardiac Catheterization Procedures; Clinical; Coronary; Coronary Arteriosclerosis; Development; Disease; Equipment; Etiology; Evaluation; Family suidae; Functional disorder; Goals; Gold; Incidence; Infarction; Invasive; Laboratories; Measures; Methods; Microcirculation; Modeling; Morbidity - disease rate; Myocardial; Myocardium; Nature; Outcome; Outcome Measure; Patients; Play; Positron-Emission Tomography; Prevalence; Research Personnel; Resistance; Role; Standards of Weights and Measures; System; Techniques; Technology; Testing; Time; Transplant Recipients; Transplantation; base; functional status; indexing; mortality; pressure; programs

DESCRIPTION (provided by applicant): Traditionally, evaluation of patients with suspected coronary artery disease has focused on the epicardial coronary system. More recently, investigators have come to appreciate better that the status of the coronary microcirculation can influence significantly long-term morbidity and mortality. Although cardiac transplant recipients commonly develop microcirculatory dysfunction, its timing and its effect on outcomes is unclear. Patients with acute myocardial infarction, despite successful recanalization of an occluded epicardial artery, suffer from microcirculatory dysfunction, both in the infarcted region, as well as in myocardium remote from the infarction. However, the incidence and implications of micro-circulatory dysfunction in areas remote from an acutely infarcted territory are poorly understood. To date, evaluation of the coronary microcirculation has been limited by techniques which incorporate the epicardial system into their assessment. Additionally, most methods require specialized equipment and/or analyses. Others are limited by their qualitative nature. Finally, the majority of methods are noninvasive, yet many patients first present for evaluation of their coronary arterial system in the cardiac catheterization laboratory. The first goal of this project is to demonstrate that an invasive, coronary wire-based method for evaluating the coronary microcirculation is easy to perform and interpret, quantitative, and correlates well with standard methods for assessing the microcirculation. The technique will be validated in a porcine model of epicardial artery and microcirculatory disease. It's correlation with PET imaging, the current gold standard noninvasive method of evaluating the microcirculation, will then be tested in patients with and without microcirculatory dysfunction. The second and third goals of this study will be to apply this technique to gain a better understanding of the role of the microcirculation in the outcomes of cardiac transplant patients and those suffering from acute myocardial infarction.

描述（由申请人提供）： 传统上，对疑似冠状动脉疾病患者的评估主要集中在心外膜冠状动脉系统。最近，研究人员开始更好地认识到冠状动脉微循环的状态可以显着影响长期发病率和死亡率。尽管心脏移植受者通常会出现微循环功能障碍，但其发生时间及其对结果的影响尚不清楚。患有急性心肌梗塞的患者，尽管闭塞的心外膜动脉成功再通，但在梗塞区域以及远离梗塞的心肌中仍遭受微循环功能障碍。然而，人们对远离急性梗塞区域的微循环功能障碍的发生率和影响知之甚少。 迄今为止，冠状动脉微循环的评估受到将心外膜系统纳入评估的技术的限制。此外，大多数方法需要专门的设备和/或分析。其他人则受到其质量性质的限制。最后，大多数方法都是非侵入性的，但许多患者首先在心导管实验室评估其冠状动脉系统。 该项目的第一个目标是证明一种用于评估冠状动脉微循环的侵入性、基于冠状动脉线的方法易于执行和解释、定量，并且与评估微循环的标准方法具有良好的相关性。该技术将在猪心外膜动脉和微循环疾病模型中得到验证。它与 PET 成像（目前评估微循环的金标准无创方法）的相关性将在有或没有微循环功能障碍的患者中进行测试。这项研究的第二个和第三个目标是应用该技术更好地了解微循环在心脏移植患者和急性心肌梗死患者的预后中的作用。