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Assessment of Coronary Flow Reserve Using TIMI Frame Count Method

Author: ChenHongLei
Tutor: LianZheXun
School: Qingdao University
Course: Department of Cardiology
Keywords: TIMI frame count method Coronary flow reserve Coronary angiography Angina Acute myocardial infarction
CLC: R541.4
Type: Master's thesis
Year: 2004
Downloads: 50
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Abstract


Objective: To evaluate and guide treatment of coronary artery disease of the coronary flow reserve (CFR) has important clinical significance, this study, through the application TIMI frame count method determination of coronary flow reserve to explore this new angiography to evaluate coronary feasibility of the disease. Methods: three groups of patients: 1) chest pain but normal coronary angiography, 50 patients (23 male patients, 27 females, mean age 57 ± 10 years), 67 collected the blood vessels; 2) 62 cases of patients with angina pectoris ( 45 males, 17 females, mean age 59 ± 9 years old), collected 72 blood vessels are the culprit artery; 3) in patients with acute myocardial infarction in 53 patients (45 male, 8 females, average age 57 ± 9 years ), collected blood vessel 53 are infarct-related arteries (IRAs). At the appropriate angle (left anterior descending artery and left circumflex branch frame count is usually in the right anterior oblique foot position, frame count of the right coronary artery, usually in the left anterior oblique) collection coronary angiography movie, application frame counter calculation contrast agent from coronal artery opening to the Remote mark the desired number of frames, the resting phase TFC (B-TFC). Intracoronary injection of adenosine triphosphate (ATP) (left coronary 50μg, right coronary 20μg) repeat angiography 15 seconds later at the same angle, Get congestive phase the TFC (H-TFC). The number of frames of the left anterior descending artery divided by 1.7 to get the corrected TIMI frame count (CTFC). Resting phase CTFC divided by congestive phase CTFC is the CFR. 35 of the culprit artery in 62 cases of patients with angina pectoris, 53 cases of patients with myocardial infarction in 48 IRAs after repeat after treatment bellows coronary intervention (PCI) (both coronary stenting) above measurements. Results: PCI angina group B-CTFC angiographically normal undifferentiated (25 ± 8 vs 25 ± 10, P> 0.05), myocardial infarction group B-CTFC was significantly higher than the the angiographically normal group with angina group (P <0.01) ; PCI angina pectoris and myocardial infarction compared with preoperative B-CTFC no significant change (P> 0.05). Before PCI angina pectoris and myocardial infarction group H-CTFC were significantly higher than normal angiography group (15 ± 7 and 26 ± 14 vs 10 ± 4, P <0.01), and myocardial infarction group H-CTFC higher than the SAP group (P < 0.01); PCI angina group H-CTFC level back to normal angiography group (P> 0.05), myocardial infarction group H-CTFC than preoperative significantly improved (26 ± 14 vs 18 ± 8, P <0.01). but still higher than the the angiographically normal group and angina group (P <0.01). Before PCI angiographically normal group CFR was significantly higher than that of angina pectoris and myocardial infarction group (2.64 ± 0.94 vs 1.79 ± 0.51 and 1.47 ± 0.28, P <0.01). Angina group of CFR after PCI than before surgery significantly improve (2.59 ± 0.98 vs 1.84 ± 0.54, P <0.01) and nearly angiography normal group, the level (P> 0.05), myocardial infarction group CFR compared with surgery, significantly increase (1.88 ± 0.08 vs 1.47 ± 0.04, P <0.01), but did not return to normal angiography group level. CFR before PCI angina group with lesions of vascular stenosis rate between a significantly negative correlation (r = -0.553, P <0.001), whereas no correlation between myocardial infarction CFR Chinese Abstract stenosis rate ( on twenty-one 0.142, P 0.311). Conclusion: as an alternative method for determination of coronary blood flow velocity, the TIMI frame count method can effectively coronary flow reserve in the evaluation of coronary artery disease state.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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