Prognostic Value of Microvascular Resistance at Rest in Patients With Takotsubo Syndrome
Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Microvascular resistance (MR) is increased in takotsubo syndrome (TTS) and can be assessed by a validated pressure-wire-free tool called nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio).
OBJECTIVES: The authors aimed to study whether the degree and extent of an altered MR in TTS patients were associated with 1-year prognosis.
METHODS: The authors recruited 181 consecutive patients with TTS who underwent cardiac angiography. Impaired MR was defined as an NH-IMRangio ≥25. The degree and extent of impaired MR were assessed by the value of maximum NH-IMRangio in each major coronary artery and by the number of coronary arteries with an NH-IMRangio ≥25, respectively. Major adverse cardiac events (MACE) were a composite of cardiovascular death, heart failure event, acute myocardial infarction, and hospitalization for symptomatic arrhythmias.
RESULTS: A total of 166 patients had NH-IMRangio available. The mean age was 74.8 years, and 83% were women. The rate of MACE at 1 year was 21.1%, mainly due to heart failure events that were generally mild. Kaplan-Meier curves showed higher rates of MACE in patients with higher NH-IMRangio (28.9% vs 13.3%; P = 0.019) and in those with 3 coronary arteries with increased MR compared to those with 2 or 1 affected arteries (33.3% vs 15.9% vs 9.5%; P = 0.040 and P = 0.040, respectively). After a multivariable Cox regression analysis, higher values of NH-IMRangio (HR: 3.41 [95% CI: 1.54-7.52]; P = 0.002) and the presence of 3 coronary arteries with increased MR (HR: 6.39 [95% CI: 1.46-27.87]; P = 0.014) were independent predictors of MACE in TTS patients.
CONCLUSIONS: The degree and extent of an impaired MR assessed by a validated pressure-wire-free tool were independent predictors of MACE at 1-year follow-up in TTS patients.
| Errataetall: |
CommentIn: JACC Cardiovasc Imaging. 2022 Oct;15(10):1796-1798. - PMID 36202459 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
JACC. Cardiovascular imaging - 15(2022), 10 vom: 01. Okt., Seite 1784-1795 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sans-Roselló, Jordi [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary microvascular dysfunction (CMD) |
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| Anmerkungen: |
Date Completed 28.09.2022 Date Revised 03.11.2022 published: Print-Electronic CommentIn: JACC Cardiovasc Imaging. 2022 Oct;15(10):1796-1798. - PMID 36202459 Citation Status MEDLINE |
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| doi: |
10.1016/j.jcmg.2022.03.030 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM346423597 |
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| 245 | 1 | 0 | |a Prognostic Value of Microvascular Resistance at Rest in Patients With Takotsubo Syndrome |
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| 500 | |a Date Revised 03.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: JACC Cardiovasc Imaging. 2022 Oct;15(10):1796-1798. - PMID 36202459 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Microvascular resistance (MR) is increased in takotsubo syndrome (TTS) and can be assessed by a validated pressure-wire-free tool called nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio) | ||
| 520 | |a OBJECTIVES: The authors aimed to study whether the degree and extent of an altered MR in TTS patients were associated with 1-year prognosis | ||
| 520 | |a METHODS: The authors recruited 181 consecutive patients with TTS who underwent cardiac angiography. Impaired MR was defined as an NH-IMRangio ≥25. The degree and extent of impaired MR were assessed by the value of maximum NH-IMRangio in each major coronary artery and by the number of coronary arteries with an NH-IMRangio ≥25, respectively. Major adverse cardiac events (MACE) were a composite of cardiovascular death, heart failure event, acute myocardial infarction, and hospitalization for symptomatic arrhythmias | ||
| 520 | |a RESULTS: A total of 166 patients had NH-IMRangio available. The mean age was 74.8 years, and 83% were women. The rate of MACE at 1 year was 21.1%, mainly due to heart failure events that were generally mild. Kaplan-Meier curves showed higher rates of MACE in patients with higher NH-IMRangio (28.9% vs 13.3%; P = 0.019) and in those with 3 coronary arteries with increased MR compared to those with 2 or 1 affected arteries (33.3% vs 15.9% vs 9.5%; P = 0.040 and P = 0.040, respectively). After a multivariable Cox regression analysis, higher values of NH-IMRangio (HR: 3.41 [95% CI: 1.54-7.52]; P = 0.002) and the presence of 3 coronary arteries with increased MR (HR: 6.39 [95% CI: 1.46-27.87]; P = 0.014) were independent predictors of MACE in TTS patients | ||
| 520 | |a CONCLUSIONS: The degree and extent of an impaired MR assessed by a validated pressure-wire-free tool were independent predictors of MACE at 1-year follow-up in TTS patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a coronary microvascular dysfunction (CMD) | |
| 650 | 4 | |a nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio) | |
| 650 | 4 | |a takotsubo syndrome (TTS) | |
| 700 | 1 | |a Fernández-Peregrina, Estefanía |e verfasserin |4 aut | |
| 700 | 1 | |a Duran-Cambra, Albert |e verfasserin |4 aut | |
| 700 | 1 | |a Carreras-Mora, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Sionis, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Álvarez-García, Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a García-García, Hector M |e verfasserin |4 aut | |
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