A Retrospective Study on Periprocedural Coronary Microvascular Dysfunction During Elective Percutaneous Coronary Intervention Assessed by Angiography-Derived Microvascular Resistance
10.13288/j.11-2166/r.2026.21.012
- VernacularTitle:基于血管造影衍生的微循环阻力评价择期经皮冠状动脉介入治疗围手术期冠状动脉微血管功能障碍的回顾性研究
- Author:
Yunze LI
1
;
Juju SHANG
2
;
Hongxu LIU
2
;
Xiang LI
2
;
Wenlong XING
2
;
Mingxuan LI
2
;
Zihao LIU
2
Author Information
1. Beijing University of Chinese Medicine，Beijing，100029
2. Beijing Hospital of Traditional Chinese Medicine，Capital Medical University
- Publication Type:Journal Article
- Keywords:
coronary microvascular dysfunction;
percutaneous coronary intervention;
coronary angiography;
microcirculatory resistance
- From:
Journal of Traditional Chinese Medicine
2026;67(21):2325-2333
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the prevalence of coronary microvascular dysfunction （CMD） during the perioperative period of elective percutaneous coronary intervention （PCI） and the incidence of deterioration in coronary microvascular function using angiography-derived microcirculatory resistance （AMR）， and to explore the influencing factors associated with PCI-related coronary microvascular injury. MethodsPatients who underwent elective PCI on the left anterior descending coronary artery at Beijing Hospital of Traditional Chinese Medicine， Capital Medical University， from January 1， 2021 to December 31， 2024 were retrospectively enrolled. AMR values of the target vessel before and after PCI were calculated to evaluate the prevalence of postoperative CMD and the incidence of microvascular functional deterioration. Multivariate analysis was performed to explore the influencing factors associated with coronary microvascular injury during the periprocedural period of PCI. ResultsA total of 204 patients were finally included. Postoperative AMR of the target vessel were significantly higher than preoperative values （P＜0.001）. The prevalence of CMD was 31.86% （65/204）， and the incidence of microvascular functional deterioration was 69.61% （142/204）. In-stent restenosis （P = 0.004） and post-balloon dilation （P = 0.002） were risk factors for CMD. Traditional Chinese medicine （TCM） syndrome elements phlegm-turbidity （P = 0.004） and blood stasis （P = 0.013）， a higher diameter stenosis rate of the target lesion （P = 0.006）， larger stent/balloon diameter （P = 0.009）， and a greater number of balloon inflations （P = 0.029） were risk factors for microvascular functional deterioration. Preoperative use of Chinese herbal decoctions with actions of resolving phlegm and activating blood （P = 0.014） was a protective factor against microvascular functional deterioration， while intraoperative use of Kuanxiong Aerosol （宽胸气雾剂） was a protective factor against both CMD （P = 0.007） and microvascular functional deterioration （P = 0.030）. ConclusionCMD and microvascular functional deterioration are relatively common during the perio-perative period of elective PCI. Target lesion characteristics， PCI procedural features， and the TCM syndrome elements of phlegm-turbidity and blood stasis are associated with an increased risk of coronary microvascular injury during the perioperative period， whereas TCM treatment may reduce this risk.
