The index of microvascular resistance identifies patients with periprocedural myocardial infarction in elective percutaneous coronary intervention.

Background: This study was designed to assess whether measurement of the index of microvascular resistance (IMR) could help prospectively identify patients who develop periprocedural myocardial infarction (PPMI).

Methods And Results: IMR was measured in 54 patients before and following percutaneous coronary intervention (PCI) in a culprit vessel with a PressureWire using the equation IMR = Pa(Hyp) × Tmn(Hyp) (Pd(Hyp)-Pw/Pa(Hyp)-Pw). IMR was also measured in an angiographically normal reference vessel.

Impact of right atrial pressure on decision-making using fractional flow reserve (FFR) in elective percutaneous intervention.

Background: We undertook a prospective study to assess the impact of routine incorporation of right atrial pressure into the calculation of FFR in a real world elective PCI cohort.

Methods: 42 patients with stenoses in 2 separate epicardial vessels at coronary angiography were studied. Using a temperature and pressure sensing guidewire (TPSG) FFR and FFRRAP were performed in the target vessel pre and post PCI and in a non-target vessel.

When collateral supply is accounted for epicardial stenosis does not increase microvascular resistance.

Background: The relationship between epicardial stenosis and microvascular resistance remains controversial. Exploring the relationship is critical, as many tools used in interventional cardiology imply minimal and constant resistance. However, variable collateralization may impact well on these measures.

Spotty pigmentation and atrial myxoma: a case report of Carney's complex.

A case of atrial myxoma that was associated with marked spotty mucocutaneous pigmentation is described. The combination of these two conditions has been described as an easily-recognized syndrome which is familial. Other features which may be associated with the syndrome are cutaneous myxomas and endocrine tumours.

Reversible cold-induced abnormalities in myocardial perfusion and function in systemic sclerosis.

The effects of peripheral cold exposure on myocardial perfusion and function were studied in 13 patients with scleroderma without clinically evident myocardial disease. Ten patients had at least one transient, cold-induced, myocardial perfusion defect visualized by thallium-201 scintigraphy, and 12 had reversible, cold-induced, segmental left ventricular hypokinesis by two-dimensional echocardiography. The 10 patients with transient perfusion defects all had anatomically corresponding ventricular wall motion abnormalities.