Related Experiment Video
Updated: Aug 9, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Relation between coronary pressure derived collateral flow, myocardial perfusion grade, and outcome in left
K P Balachandran1, C Berry, J Norrie
1Lanarkshire Cardiac Catheterisation Laboratories, Hairmyres Hospital, East Kilbride. kanarath_balachandran@hotmail.com
Insights
Pressure derived coronary collateral flow (PDCF) does not predict left ventricular function recovery after rescue PCI for acute myocardial infarction. Increased PDCF and wedge pressure indicate dysfunctional microcirculation, not protective collateral function.
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Infarction Research
Background:
- Assessing coronary collateral flow is crucial in acute myocardial infarction (AMI) management.
- Rescue percutaneous coronary intervention (PCI) is performed for failed reperfusion.
- Evaluating predictors of left ventricular (LV) function recovery post-PCI is essential.
Purpose of the Study:
- To investigate the relationship between the pressure derived coronary collateral flow (PDCF) index and myocardial perfusion.
- To determine if PDCF predicts left ventricular function recovery after rescue PCI in AMI.
- To correlate PDCF with angiographic collateral grading and perfusion.
Main Methods:
- A pressure wire was used as a guidewire in 38 patients undergoing rescue PCI.
- Follow-up angiography and ventriculograms were analyzed at six months.
- A linear model assessed the association between PDCF and changes in LV regional wall motion.
Main Results:
- Patients with TIMI myocardial perfusion (TMP) 0 grade showed significantly higher PDCF than those with TMP 1-3 (0.30 vs. 0.15, p < 0.0001).
- Higher PDCF correlated with increased left ventricular end-diastolic pressures.
- No significant correlation was found between PDCF and Rentrop collateral grade, nor between PDCF changes and LV regional wall motion improvements.
Conclusions:
- PDCF in the context of rescue PCI for failed reperfusion does not predict improvement in left ventricular function.
- Elevated PDCF and coronary wedge pressure in AMI suggest microcirculatory dysfunction rather than effective collateral protection.
Objective:
To evaluate the relation between pressure derived coronary collateral flow (PDCF) index and angiographic TIMI (thrombolysis in myocardial infarction) myocardial perfusion (TMP) grade, angiographic collateral grade, and subsequent recovery of left ventricular function after rescue percutaneous coronary intervention (PCI) for failed reperfusion in acute myocardial infarction.
Methods:
The pressure wire was used as the guidewire in 38 consecutive patients who underwent rescue PCI between December 2000 and March 2002. Follow up angiography was performed at six months. Baseline and follow up single plane ventriculograms were analysed off line by an automated edge detection technique. A linear model was fitted to assess the relation between 0.1 unit increase in PDCF and change in left ventricular regional wall motion.
Results:
Patients with TMP 0 grade had significantly higher mean (SD) PDCF than patients with TMP 1-3 (0.30 (0.11) v 0.15 (0.07), p < 0.0001, r = -0.5). A similar relation was observed between TMP grade and coronary wedge pressure (mean (SD) 28 (16) mm Hg with TMP 0 v 9 (7) mm Hg with TMP 1-3, p = 0.001, r = -0.4). Higher PDCF was associated with increased left ventricular end diastolic pressures (0.28 (0.14) with end diastolic pressure > 20 mm Hg v 0.22 (0.09) with end diastolic pressure < 20 mm Hg, p = 0.08, r = 0.2). No correlation was observed between PDCF and Rentrops collateral grade (0.26 (0.13) with grade 0 v 0.25 (0.11) with grades 1-3, p = 0.4, r = -0.06). No linear relation existed between changes in PDCF and changes in left ventricular regional wall motion.
Conclusion:
PDCF in the setting of rescue PCI for failed reperfusion after thrombolysis does not predict improvement in left ventricular function. Increased PDCF and coronary wedge pressure in acute myocardial infarction reflect a dysfunctional microcirculation rather than good collateral protection.
