Influence of nitroglycerin on fractional flow reserve and myocardial perfusion in patients with coronary artery ectasia: a review through fractional flow reserve combining myocardial contrast echocardiography
ZHU Xi
CHEN Sha-sha
NING Zhong-ping
CONG Xin-peng
LI Xin-ming
Abstract：Objective To review fractional flow reserve (FFR) and myocardial perfusion by applying FFR combining myocardial contrast echocardiography (MCE) in patients with coronary artery ectasia (CAE) after nitroglycerin administration.Methods The study was approved by the Ethics Committee of Zhoupu Hospital of Shanghai Pudong New Area. CAE patients diagnosed by coronary angiography (CAG) were chosen (n=53), and the changes of flow reserve were detected and reviewed by using FFR (Pd/Pa) before and after nitroglycerin administration. The influence of nitroglycerin on myocardial perfusion was reviewed by using grading of MCE myocardial perfusion imagining. The difference in FFR values and scores of MCE myocardial perfusion imagining of localized and diffuse CAF lesion vessels were compared and analyzed.Results There were 62 CAE coronary arteries in chosen patients, of which there were 44 localized CAE vessels and 18 diffuse CAE vessels. There were 14 vessels (22.6%) were complicated by coronary artery stenosis (over 50%) at the same time. Before nitroglycerin administration, the mean value of FFR was (0.756±0.0554) in localized CAE group and (0.734±0.0877) in diffuse CAE group, and the difference was not significant (P=0.269). After nitroglycerin administration, the mean value of FFR was significantly higher in localized CAE group than that in diffuse CAE group (P<0.001). The mean value of FFR increased significantly (P=0.001), and scores of MCE myocardial perfusion imagining increased significantly too (P<0.001) in CAE vessels complicated by coronary artery stenosis after nitroglycerin administration. Conclusion The effect of nitroglycerin is different on different types of CAE lesions, and flow reserve and myocardial perfusion can be improved in patients with localized CAE and those with diffuse CAE have less efficacy.
Keywords：Coronary artery ectasiaFractional flow reserveMyocardial contrast echocardiography
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 682-686 )