The Predictive Value Of The Index Of Microcirculatory Resistance(IMR) In Patients Undergoing Elective Percutaneous Coronary Intervention(PCI) For ST-segment Elevation Myocardial Infarction(STEMI) With Or Without Collateral Circulation

Objectives: The objective of this study is to evaluate the predictive value of the index of microcirculatory resistance(IMR) in patients undergoing elective percutaneous coronary intervention(PCI) for ST-segment elevation myocardial infarction(STEMI) with or without collateral circulation collateral circulation.Methods: this study is to choice 34 patients of ST segment elevation myocardial infarction(STEMI) miss blood supply reconstruction time(>12h), in January 2012 ~ March 2014 in the inpatient department of Cardiology; Qingdao Municipal Hospital, these patients were performed coronary angiography and PCI after 15 days, 28 males and 6 females, age 31~82 years old(63.0 ± 12.4 years).according to the Rentrop grade, these patients were divided into 2 groups: collateral circulation formation group(group A, Rentrop=2-3, n = 19) and collateral circulation formation adverse group(group B, Rentrop=0-1, n = 15), all patients underwent coronary angiography and stent implantation, then detected IMR,and measured left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF) in preoperative and postoperative 3 months.Results: Comparison of two groups of age, gender, hypertension, diabetes mellitus and chronic myocardial infarction, there was no statistically significant difference(P > 0.05). Compared with B group, IMR decreased(32 + 7.6) vs.(21.2 + 4.5) in the A group, the difference was statistically significant(P < 0.01). The LVEF of A group of PCI postoperative 3 months was significantly higher than that of PCI preoperative, and the difference was statistically significant(P<0.05),it is suggested that the cardiac function of the patients with PCI can make recovery of good collateral circulation. LVEDD in B group was increased after 3 months operation, the difference was statistically significant(P < 0.05), indicating poor collateral circulation although the patients completed the PCI operation, but recently there may be left ventricular dilatation, heart function deterioration. Although the patients of the poor collateral circulation completed the PCI operation, but recently there may be left ventricular dilatation and heart function deterioration.Conclusion: Poor coronary collateral circulation in ST segment elevation myocardial infarction in patients is more prone to microcirculatory dysfunction, heart function after PCI than in patients with good coronary collateral circulation, heart function of poor coronary collateral circulation after PCI got worse.