Angiography-derived index of microcirculatory resistance as a novel, pressure-wire-free tool to assess coronary microcirculation in ST elevation myocardial infarction

Autor: De Maria, GL, Scarsini, R, Shanmuganathan, M, Kotronias, RA, Terentes-Printzios, D, Borlotti, A, Langrish, JP, Lucking, AJ, Choudhury, RP, Kharbanda, R, Ferreira, VM, Investigators, Oxford Acute Myocardial Infarction (OXAMI) Study, Channon, KM, Garcia-Garcia, HM, Banning, AP
Rok vydání: 2020
Předmět:
Male
Cardiac Catheterization
medicine.medical_specialty
medicine.medical_treatment
Coronary Artery Disease
Coronary microcirculation
Coronary Angiography
Cardiac Catheters
STEMI
Hyperaemia
Index of microcirculatory resistance
Predictive Value of Tests
St elevation myocardial infarction
Coronary Circulation
Internal medicine
Transducers
Pressure
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Angioplasty
Balloon
Coronary
Cardiac imaging
Aged
Original Paper
medicine.diagnostic_test
business.industry
Microcirculation
Area under the curve
Reproducibility of Results
Percutaneous coronary intervention
Magnetic resonance imaging
Middle Aged
Microvascular obstruction
Coronary Vessels
Magnetic Resonance Imaging
Quantitative flow ratio
Microvascular dysfunction
Angiography
Cardiology
Radiographic Image Interpretation
Computer-Assisted
ST Elevation Myocardial Infarction
Female
Stents
Vascular Resistance
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Zdroj: The International Journal of Cardiovascular Imaging
ISSN: 1573-0743
1569-5794
DOI: 10.1007/s10554-020-01831-7
Popis: Immediate assessment of coronary microcirculation during treatment of ST elevation myocardial infarction (STEMI) may facilitate patient stratification for targeted treatment algorithms. Use of pressure-wire to measure the index of microcirculatory resistance (IMR) is possible but has inevitable practical restrictions. We aimed to develop and validate angiography-derived index of microcirculatory resistance (IMRangio) as a novel and pressure-wire-free index to facilitate assessment of the coronary microcirculation. 45 STEMI patients treated with primary percutaneous coronary intervention (pPCI) were enrolled. Immediately before stenting and at completion of pPCI, IMR was measured within the infarct related artery (IRA). At the same time points, 2 angiographic views were acquired during hyperaemia to measure quantitative flow ratio (QFR) from which IMRangio was derived. In a subset of 15 patients both IMR and IMRangio were also measured in the non-IRA. Patients underwent cardiovascular magnetic resonance imaging (CMR) at 48 h for assessment of microvascular obstruction (MVO). IMRangio and IMR were significantly correlated (ρ: 0.85, p 1.55% of left ventricular mass) (p = 0.03 and p = 0.005, respectively). Post-pPCI IMRangio presented and area under the curve (AUC) of 0.96 (CI95% 0.92–1.00, p 40U and of 0.81 (CI95% 0.65–0.97, p 1.55%. IMRangio is a promising tool for the assessment of coronary microcirculation. Assessment of IMR without the use of a pressure-wire may enable more rapid, convenient and cost-effective assessment of coronary microvascular function. Electronic supplementary material The online version of this article (10.1007/s10554-020-01831-7) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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