Reference values for intracoronary Doppler flow velocity-derived hyperaemic microvascular resistance index.

Autor: Feenstra RGT; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Seitz A; Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany., Boerhout CKM; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., de Winter RJ; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Ong P; Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany., Beijk MAM; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Piek JJ; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Sechtem U; Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany., van de Hoef TP; Amsterdam UMC, Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands. Electronic address: t.p.vandehoef@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 Jan 15; Vol. 371, pp. 16-20. Date of Electronic Publication: 2022 Sep 27.
DOI: 10.1016/j.ijcard.2022.09.054
Abstrakt: Background: Invasive assessments of microvascular function are rapidly becoming an integral part of physiological assessment in chronic coronary syndromes.
Objective: We aimed to establish a reference range for Doppler flow velocity-derived hyperaemic microvascular resistance index (HMR) in a cohort of angina with no significant epicardial coronary obstruction (ANOCA) patients with no structural pathophysiological alterations in the coronary circulation.
Methods: The reference population consisted of ANOCA patients undergoing invasive coronary vasomotor function assessment who had a coronary flow reserve (CFR) >2.5, and had either (1) tested negatively for spasm provocation (n = 12) or (2) tested positively with only angina at rest (n = 29). A reference range for HMR was established using a non-parametric method and correlations with clinical characteristics were determined using a spearman rank correlation analysis.
Results: In 41 patients median HMR amounted to 1.6 mmHg/cm/s [Q1, Q3: 1.3, 2.2 mmHg/cm/s]. The reference range for HMR that is applicable to 95% of the population was 0.8 mmHg/cm/s (90% CI: 0.8-1.0 mmHg/cm/s) to 2.7 mmHg/cm/s (90% CI: 2.6-2.7 mmHg/cm/s). No significant correlations were found between HMR and clinical characteristics.
Conclusion: In this reference population undergoing invasive coronary vasomotor function testing, the 90% confidence interval of the HMR upper limit of normal ranges from 2.6 to 2.7 mmHg/cm/s. A > 2.5 mmHg/cm/s HMR threshold can be used to identify abnormal microvascular resistance in daily clinical practice.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: