Skip Navigation

European Heart Journal 1987 8(4):347-353;
Copyright © 1987 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by GRIFFIN, B.
Right arrow Articles by SOWTON, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by GRIFFIN, B.
Right arrow Articles by SOWTON, E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1987 The European Society of Cardiology

The evolution of myocardial ischaemia during percutaneous transluminal coronary angioplasty

B. GRIFFIN, A. D. TIMMIS, J. C. P. CRICK and E. SOWTON

Department of Cardiology, Guy's Hospital, St Thomas Street London SE1 9RT, U.K.

Received 28 August 1986; .

Address for correspondence: Brian Griffin, Department of Cardiology, Guy's Hospital, St. Thomas Street, London SE1 9RT, England.

Abstract

Balloon inflation during percutaneous transluminal coronary angioplasty is a useful human model of acute coronary occlusion and regional myocardial ischaemia. We assessed the prevalence and duration of ischaemia during successive sixty-second balloon inflations in sixteen patients undergoing routine single vessel angioplasty by continuous six lead electrocardiography and cross-sectional echocardiography. The influence of rate-pressure product on the evolution of ischaemia was also evaluated. ST segment elevation developed in fourteen of the patients within 19 ± 12 seconds and returned to baseline within 20 ± 9 seconds of deflation. Reciprocal ST segment depression occurred in four patients, only one of whom had multivessel disease. Wall motion abnormalities on echocardiography occurred in all sixteen patients and were seen significantly earlier than electrocardiographic changes. Thus, dyskinesis developed 15 ± 5 seconds after balloon inflation and disappeared 13 ± 3 seconds following balloon deflation. Time to onset of ischaemia by both methods remained constant during successive balloon inflations. Rate pressure product prior to balloon inflation correlated inversely with time to onset of ischaemia detected by either technique: r = –0.73, P <0.05 (ECG), r= –0.65, P < 0.05 (echocardiography). Nevertheless, evidence of ischaemia developed within 30 seconds in all patients regardless of rate-pressure product. This investigation indicates that electrocardiography and cross-sectional echocardiography have similar sensitivity for the detection of acute ischaemia during coronary angioplasty although echocardiographic change is seen significantly earlier. Resting myocardial oxygen consumption, as reflected by rate-pressure product, is an important determinant of time to onset of ischaemia following balloon inflation.

Key Words: Balloon inflation • PTCA • regional myocardial ischaemia


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
I.B.A Menown, J Allen, J.M. Anderson, and A.A.J Adgey
ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction
Eur. Heart J., February 1, 2001; 22(3): 218 - 227.
[Abstract] [PDF]

Home page
 CirculationHome page
P. Stubbs, P. Collinson, D. Moseley, T. Greenwood, and M. Noble
Prognostic Significance of Admission Troponin T Concentrations in Patients With Myocardial Infarction
Circulation, September 15, 1996; 94(6): 1291 - 1297.
[Abstract] [Full Text]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.