Key result
Coronary pressure measurements using the hyperaemic Pd/Pa ratio can identify ischaemic myocardial territories in recent MI, but should be used cautiously during the acute phase.
Coronary pressure measurements using the hyperaemic P(d)/P(a) ratio can identify ischaemic territories in recent MI but require caution during the acute phase due to microvascular impairment.
The development of pressure monitoring guide-wires has facilitated the measurements of coronary pressures distal to a stenosis. The ratio of the distal coronary and aortic pressures (P(d)/P(a)) measured during maximal hyperaemia is a useful index for diagnosis and monitoring the treatment of patients with coronary artery disease and for guiding percutaneous coronary intervention. However, the role of coronary pressure measurements in post- myocardial infarction (MI) patients is not well established. Coronary pressure measurements should be used with caution during the acute phase of MI due to serious micro-vascular impairment. The hyperaemic pressure P(d)/P(a) ratio can identify ischaemic myocardial territories in patients with recent MI. Theoretically, coronary pressure measurements may be of value in predicting myocardial recovery after revascularization in post-MI patients with a moderate stenosis of the infarct-related artery and without angiographically evident collaterals.
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Katsouras et al. (2006) conducted a review in post-myocardial infarction. Coronary pressure measurements was evaluated. Coronary pressure measurements using the hyperaemic Pd/Pa ratio can identify ischaemic myocardial territories in recent MI, but should be used cautiously during the acute phase.
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