Coronary microvascular dysfunction assessed by continuous intracoronary thermodilution: A comparative study with index of microvascular resistance
| Autor: | Fernando Alfonso, Alejandro Gutierrez-Barrios, Elena Izaga-Torralba, Ana Pardo-Sanz, Teresa Bastante, Fernando Rivero, Josep Gomez-Lara, Manuel Fuentes-Ferrer, Marcos García-Guimaraes, Joan-Antoni Gomez-Hospital, Nico H.J. Pijls, Javier Cuesta, Daniëlle C J Keulards |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Standard of care Thermodilution Population Fractional flow reserve 030204 cardiovascular system & hematology Anterior Descending Coronary Artery Coronary Angiography 03 medical and health sciences Microvascular resistance 0302 clinical medicine Coronary Circulation Internal medicine Humans Medicine 030212 general & internal medicine education education.field_of_study business.industry Microcirculation Coronary flow reserve Infusion catheter Coronary Vessels Fractional Flow Reserve Myocardial Cardiology Vascular Resistance Cardiology and Cardiovascular Medicine business Area under the roc curve |
| Zdroj: | International Journal of Cardiology. 333:1-7 |
| ISSN: | 0167-5273 |
| Popis: | Background This study aimed to assess the correlation between the standard of care, the index of microvascular resistance (IMR) versus the novel microvascular resistance (Rmicro) and to determine the pathologic cut-off value in a selected population with suspected coronary microvascular dysfunction (CMD). Methods One-hundred and twenty patients with high clinical suspicion of CMD due to ischemic symptoms in the absence of significant epicardial coronary lesions were prospectively included. Following a standardized systematic protocol, coronary flow reserve, IMR, fractional flow reserve, Q and Rmicro were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire and a dedicated infusion catheter. Results There was a high prevalence of CMD with 50 (42%) patients showing an IMR ≥ 25. Median IMR was 23 [IQR: 14–34] and median Rmicro was 464 Woods Units (WU) [IQR: 354–636WU]. ROC analyses identified 500 WU as the optimal Rmicro cut-off to identify patients with an IMR ≥ 25, with an area under the ROC curve (C statistic) of 0.83 (95% CI: 0.74 to 0.89, p Conclusions Rmicro derived from continuous intracoronary thermodilution is an accurate index to measure microvascular resistances enabling the invasive diagnostic of CMD. |
| Databáze: | OpenAIRE |
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