Angiography-derived index of microcirculatory resistance (IMRangio) as a novel pressure-wire-free tool to assess coronary microvascular dysfunction in acute coronary syndromes and stable coronary artery disease
To investigate the diagnostic accuracy of (1) hyperaemic angiography-derived index of microcirculatory resistance (IMRangio) in defining coronary microvascular dysfunction (CMD) across patients with acute coronary syndromes (ST-elevation myocardial infarction [STEMI]; non-ST elevation acute coronary syndrome [NSTE-ACS]) and stable chronic coronary syndrome [CCS]) and (2) the accuracy of non-hyperaemic IMRangio (NH-IMRangio) to detect CMD in STEMI. 145 patients (STEMI = 66; NSTEMI = 43; CCS = 36) were enrolled. 246 pressure-wire IMR measurements were made in 189 coronary vessels. IMRangio and NH-IMRangio was derived using quantitative flow ratio. In patients with STEMI, cardiac magnetic resonance was performed to quantify microvascular obstruction (MVO). IMRangio was correlated with IMR (overall rho = 0.78, p < 0.0001; STEMI, rho = 0.85 p < 0.0001; NSTE-ACS and rho = 0.72, p < 0.0001; CCS, rho = 0.70, p < 0.0001) and demonstrated good diagnostic performance in predicting high IMR (STEMI AUCROC = 0.93 [0.88-0.98]; NSTE-ACS AUCROC = 0.77 [0.63-0.92]; CCS AUCROC = 0.88 [0.79-0.97]). Agreement between the two indices was evident on Bland Altman analysis. In STEMI, NH-IMRangio was also well correlated with IMR (rho = 0.64, p < 0.0001), with good diagnostic accuracy in predicting high invasive IMR (AUCROC = 0.82 [0.74-0.90]). Both IMRangio (AUCROC = 0.74 [0.59-0.89]) and NH-IMRangio (AUCROC = 0.76 [0.54-0.87]) were significantly associated with MVO in STEMI. In conclusions, IMRangio is a valid alternative to invasive IMR to detect CMD in patients with acute and stable coronary syndromes, whilst NH-IMRangio has a good diagnostic accuracy in STEMI where it could become a user-friendly diagnostic tool as it is adenosine-free.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
The international journal of cardiovascular imaging - 37(2021), 6 vom: 05. Juni, Seite 1801-1813 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Scarsini, Roberto [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary microvascular dysfunction |
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| Anmerkungen: |
Date Completed 15.10.2021 Date Revised 15.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10554-021-02254-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM325032122 |
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| 100 | 1 | |a Scarsini, Roberto |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Angiography-derived index of microcirculatory resistance (IMRangio) as a novel pressure-wire-free tool to assess coronary microvascular dysfunction in acute coronary syndromes and stable coronary artery disease |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 15.10.2021 | ||
| 500 | |a Date Revised 15.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a To investigate the diagnostic accuracy of (1) hyperaemic angiography-derived index of microcirculatory resistance (IMRangio) in defining coronary microvascular dysfunction (CMD) across patients with acute coronary syndromes (ST-elevation myocardial infarction [STEMI]; non-ST elevation acute coronary syndrome [NSTE-ACS]) and stable chronic coronary syndrome [CCS]) and (2) the accuracy of non-hyperaemic IMRangio (NH-IMRangio) to detect CMD in STEMI. 145 patients (STEMI = 66; NSTEMI = 43; CCS = 36) were enrolled. 246 pressure-wire IMR measurements were made in 189 coronary vessels. IMRangio and NH-IMRangio was derived using quantitative flow ratio. In patients with STEMI, cardiac magnetic resonance was performed to quantify microvascular obstruction (MVO). IMRangio was correlated with IMR (overall rho = 0.78, p < 0.0001; STEMI, rho = 0.85 p < 0.0001; NSTE-ACS and rho = 0.72, p < 0.0001; CCS, rho = 0.70, p < 0.0001) and demonstrated good diagnostic performance in predicting high IMR (STEMI AUCROC = 0.93 [0.88-0.98]; NSTE-ACS AUCROC = 0.77 [0.63-0.92]; CCS AUCROC = 0.88 [0.79-0.97]). Agreement between the two indices was evident on Bland Altman analysis. In STEMI, NH-IMRangio was also well correlated with IMR (rho = 0.64, p < 0.0001), with good diagnostic accuracy in predicting high invasive IMR (AUCROC = 0.82 [0.74-0.90]). Both IMRangio (AUCROC = 0.74 [0.59-0.89]) and NH-IMRangio (AUCROC = 0.76 [0.54-0.87]) were significantly associated with MVO in STEMI. In conclusions, IMRangio is a valid alternative to invasive IMR to detect CMD in patients with acute and stable coronary syndromes, whilst NH-IMRangio has a good diagnostic accuracy in STEMI where it could become a user-friendly diagnostic tool as it is adenosine-free | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronary microvascular dysfunction | |
| 650 | 4 | |a IMRangio | |
| 650 | 4 | |a Index of microcirculatory resistance | |
| 650 | 4 | |a NSTE-ACS | |
| 650 | 4 | |a QFR | |
| 650 | 4 | |a STEMI | |
| 650 | 4 | |a Stable chronic coronary syndrome | |
| 700 | 1 | |a Shanmuganathan, Mayooran |e verfasserin |4 aut | |
| 700 | 1 | |a Kotronias, Rafail A |e verfasserin |4 aut | |
| 700 | 1 | |a Terentes-Printzios, Dimitrios |e verfasserin |4 aut | |
| 700 | 1 | |a Borlotti, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Langrish, Jeremy P |e verfasserin |4 aut | |
| 700 | 1 | |a Lucking, Andrew J |e verfasserin |4 aut | |
| 700 | 0 | |a OxAMI Study Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Ribichini, Flavio |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Vanessa M |e verfasserin |4 aut | |
| 700 | 1 | |a Channon, Keith M |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Garcia, Hector M |e verfasserin |4 aut | |
| 700 | 1 | |a Banning, Adrian P |e verfasserin |4 aut | |
| 700 | 1 | |a De Maria, Giovanni Luigi |e verfasserin |4 aut | |
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