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Updated: Jan 22, 2026

Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
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Published on: October 11, 2022

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The Relationship of Capillary Blood Flow Assessments with Real Time Myocardial Perfusion Echocardiography to

David Barton1, Feng Xie1, Edward O'Leary1

  • 1University of Nebraska Medical Center, Omaha, Nebraska.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|July 8, 2019
PubMed

Insights

Abnormal microvascular perfusion (MVP) is common in intermediate coronary stenoses, even with normal fractional flow reserve (FFR). Increased microvascular resistance often underlies these abnormal MVP responses in coronary artery disease.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Physiology

Background:

  • Coronary artery disease (CAD) involves microvascular dysfunction.
  • Abnormal microvascular flow responses are linked to stenosis and capillary resistance.

Purpose of the Study:

  • To investigate microvascular perfusion (MVP) responses during stress in intermediate coronary stenoses.
  • To determine if abnormal MVP occurs with normal fractional flow reserve (FFR) due to increased microvascular resistance.

Main Methods:

  • Assessed 49 coronary arteries in 41 patients with intermediate stenoses (40%-80%).
  • Measured invasive coronary hemodynamics (FFR, CFR, HMR) during adenosine stress.
  • Evaluated MVP by blinded expert reviewers.

Main Results:

  • 34 of 49 vessels showed abnormal MVP.
  • MVP detected abnormal FFR with 100% sensitivity.
  • Abnormal FFR (<0.8) was found in 44% of abnormal MVP cases.
  • Hyperemic microvascular resistance (HMR) was abnormal in 94% of abnormal MVP cases.

Conclusions:

  • Abnormal MVP is sensitive for detecting abnormal FFR but often occurs when FFR is normal.
  • Increased microvascular resistance is a frequent finding in patients with intermediate stenoses and abnormal MVP.
Abstract

Keywords:
Contrast echocardiographyFlow reserveMicrovascular resistance

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