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Experimental validation of coronary stenosis severity and development of ischemic myocardium.

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Author information

Affiliations

  • 1. Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
      Authors
    • Myung Lee J 1
    • Hong D 1
    • Hong Choi K 1
    • Kyu Park T 1
    • Hoon Yang J 1
    • Bin Song Y 1
    • Hahn JY 1
    • Choi SH 1
    • Gwon HC 1
    (9 authors)
  • 2. Department of Internal Medicine and Cardiovascular Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
      Authors
    • Hun Lee S 2
    • Byul Kim H 2
    • Ahn Y 2
    • Ho Jeong M 2
    • Joon Hong Y 2
    (5 authors)
  • 3. Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
      Authors
    • Kwon W 3
    (1 author)
  • 4. Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine, Gwangju, Korea.
      Authors
    • Kuk Kim H 4
    (1 author)
  • 5. Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
      Authors
    • Cho SG 5
    • Seong Park K 5
    • Kim J 5
    • Bae Moon J 5
    • Song HC 5
    (5 authors)
    • Show all (8)

Revista Espanola de Cardiologia (English ed.), 26 Oct 2024, :S1885-5857(24)00312-8
https://doi.org/10.1016/j.rec.2024.10.006 PMID: 39490529 

Abstract 

Introduction and objectives

The current study aimed to evaluate the causal association between hemodynamically significant stenosis and the occurrence of ischemic myocardium using an experimental animal model of coronary artery stenosis.

Methods

In Yorkshire swine (n = 10), coronary stenosis in the left anterior descending artery was induced using a customized vascular occluder to create varying degrees of occlusion severity (40%-99%). Serial changes in coronary pressure and flow velocity were measured in the left anterior descending artery before and after the implantation of the vascular occluder. At 1 month, 13N-ammonia positron emission tomography (PET) was performed, followed by the collection of isolated hearts for 2,3,5-Triphenyltetrazolium chloride (TTC) staining to quantify the percent area of necrotic myocardium. Three animals in the control group were evaluated using the same protocols, but without the implantation of a vascular occluder Results: The median diameter stenosis after vascular occluder implantation was 61.3% (Q1-Q3: 55.9%-72.3%). Significant differences were observed in hyperemic stenosis resistance, fractional flow reserve (FFR), stress perfusion defect and reversibility in PET, as well as in necrotic myocardium in TTC staining based on stenosis severity (control group: < 50%, 50%-70%, 70%-90%, and > 90%) (all P < .010). Animals with FFR < 0.75 at 1 month exhibited a significantly higher area of stress perfusion defect (30.7 ± 3.1% vs 6.0 ± 4.2%, P < .001), reversibility in PET (11.0 ± 4.0% vs 0.0 ± 0.0%, P = .006), and necrotic myocardium in TTC staining (15.8 ± 6.4% vs 0.0 ± 0.0%, P < .001) than those with FFR ≥ 0.75.

Conclusions

In a porcine model, the induction of hemodynamically significant stenosis with FFR < 0.75 was associated with the development of stress perfusion defects and reversibility in PET, as well as necrotic myocardium identified by pathology.

Full text links 

Read article at publisher's site: https://doi.org/10.1016/j.rec.2024.10.006

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