Key result
Elective PCI linked to a ~50% increase in FFR and restored phasic cardiac-coronary coupling.
Why the study?
The clinical benefit of PCI in chronic coronary syndromes remains controversial, and coronary wave intensity analysis offers mechanistic insights into cardiac-coronary coupling.
Does elective percutaneous coronary intervention improve phasic cardiac-coronary interaction and haemodynamics in patients with chronic coronary syndromes?
Observational (n=27)
Does elective percutaneous coronary intervention improve phasic cardiac-coronary interaction and haemodynamics in patients with chronic coronary syndromes?
Elective PCI in chronic coronary syndromes significantly improves epicardial and microvascular haemodynamics, restoring phasic cardiac-coronary coupling as assessed by wave intensity analysis.
Supports physiological benefits of elective PCI in chronic coronary syndromes; leaves open impact on clinical outcomes.
BACKGROUND: Clinical benefit of percutaneous coronary intervention (PCI) in chronic coronary syndromes (CCS) remains controversial. Coronary wave intensity analysis (WIA) provides mechanistic insights into cardiac-coronary coupling. OBJECTIVES: To assess peri-PCI WIA changes at rest and during hyperaemia, and to identify features associated with improvements in epicardial and microvascular resistance. METHODS: Intracoronary Doppler and pressure measurements were analysed in 27 CCS patients undergoing elective PCI. Haemodynamics (fractional flow reserve (FFR), basal and hyperaemic stenosis resistance (bSR, hSR), coronary flow reserve (CFR), basal and hyperaemic microvascular resistance (bMR, hMR)) and WIA metrics (forward compression wave (FCW), backward compression wave (BCW), forward expansion wave (FEW), backward expansion wave (BEW), wave speed) were quantified at rest and hyperaemia. RESULTS: PCI reduced bSR and hSR (p<0.001), increased FFR (0.58±0.18 to 0.87±0.09; p<0.001) and CFR (1.68±0.47 to 2.79±0.62; p<0.001), and lowered hMR (2.22 (1.67-3.10) to 1.49 (1.18-1.74); p<0.001). At rest, PCI increased FCW (40.3±48.9 to 89.3±64.8; p=0.022), FEW (24.5 (7.2-42.8) to 58.8 (24.0-93.1); p=0.001) and BEW (57.6±70.6 to 82.1±51.8; p=0.017). Hyperaemic backward wave peaks augmented significantly (BCW: 77.8±53.3 to 172.8±112.3; BEW: 60.5±47.5 to 126.7±66.2; both p<0.001). WIA time-to-peaks occurred earlier post-PCI. Reduced resting wave speed (41±21 to 25±10 m/s; p<0.001) correlated with hMR decreases (r=0.77; p<0.001). Increased resting BEW correlated with total vascular resistance reductions (hSR+hMR; r=-0.76; p<0.001). CONCLUSIONS: Elective PCI restores phasic cardiac-coronary coupling. Resting BEW and coronary wave speed provide complementary physiological endpoints reflecting microvascular and epicardial recovery, warranting larger prospective evaluation.
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Taş et al. (2026) conducted an observational in Chronic coronary syndromes (n=27). Percutaneous coronary intervention vs. Pre-PCI (baseline) was evaluated on Fractional flow reserve (FFR) (p=<0.001). Elective percutaneous coronary intervention significantly increased fractional flow reserve from 0.58 to 0.87 (P<0.001) and restored phasic cardiac-coronary coupling.
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