{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Cardiovascular Sciences, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands",
        "Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "Ahmet Taş, MD PhD"
    },
    {
      "affiliations": [
        "Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "Yaren Alan MD"
    },
    {
      "affiliations": [
        "Department of Cardiology, Koc University School of Medicine, Istanbul, Turkey"
      ],
      "name": "Alp Ozcan MD"
    },
    {
      "affiliations": [
        "Department of Pathology, Istanbul Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "Ilke Kara Taş MD"
    },
    {
      "affiliations": [
        "Istanbul Medipol University International School of Medicine, Beykoz, Turkey"
      ],
      "name": "Nehir Taş"
    },
    {
      "affiliations": [
        "National Amyloidosis Centre, Royal Free Hospital, London, UK"
      ],
      "name": "Irem Sezer MD"
    },
    {
      "affiliations": [
        "Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands"
      ],
      "name": "Tim P van de Hoef, MD PhD"
    },
    {
      "affiliations": [
        "Department of Bioengineering, Imperial College London, London, UK"
      ],
      "name": "Kim H. Parker, PhD"
    },
    {
      "affiliations": [
        "Department of Cardiology, Acıbadem International Hospital, Istanbul, Turkey"
      ],
      "name": "Murat Sezer MD"
    },
    {
      "affiliations": [
        "Cardiovascular Sciences, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"
      ],
      "name": "Jan J Piek, MD PhD"
    }
  ],
  "title": "Percutaneous coronary interventions improve phasic cardiac–coronary interaction in chronic coronary syndromes as assessed by wave intensity analysis",
  "uid": "bfa12bb3-c31a-5916-93b3-1e0b10d36f23"
}