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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제57권 제1호
발행연도
2016.1
수록면
58 - 63 (6page)

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Purpose: When performing coronary angiography (CAG), diagnostic catheter intubation to the ostium can cause damping of thepressure tracing. The aim of this study was to determine the predictors of atherosclerotic ostial stenosis in patients showing pressuredamping during CAG. Materials and Methods: In total, 2926 patients who underwent diagnostic CAG were screened in this study. Pressure dampingwas defined as an abrupt decline of the coronary blood pressure with a blunted pulse pressure after engagement of the diagnosticcatheter. According to CAG and intravascular ultrasound (IVUS), we divided damped ostia into two groups: atherosclerotic ostiallesion group (true lesion group) and non-atherosclerotic ostium group (false lesion group). Clinical and angiographic characteristicswere compared between the two groups. Results: The overall incidence of pressure damping was 2.3% (68 patients and 76 ostia). Among the pressure damped ostia, 40.8%(31 of 76 ostia) were true atherosclerotic ostial lesions (true lesion group). The true lesion group had more frequent left main ostialdamping and more percutaneous coronary interventions (PCIs) performed on non-ostial lesions, compared to the false lesiongroup. On multivariate logistic regression analysis, left main ostial damping [hazard ratio (HR) 4.11, 95% confidence interval (CI)1.24–13.67, p=0.021] and PCI on non-ostial lesion (HR 5.34, 95% CI 1.34–21.27, p=0.018) emerged as independent predictors fortrue atherosclerotic ostial lesions in patients with pressure damping. Conclusion: Left main ostial damping and the presence of a non-ostial atherosclerotic lesion may suggest a significant true atheroscleroticlesion in the coronary ostium.

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