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Coronary Angiography-Derived Index of Microvascular Resistance
Hu Ai1,2, Yundi Feng3, Yanjun Gong4
1Department of Cardiology, Beijing Hospital, Beijing, China.
Frontiers in Physiology
|January 4, 2021
Summary
A new coronary angiography-derived index of microvascular resistance (caIMR) accurately assesses microvascular diseases without a pressure wire. This method shows high diagnostic performance, potentially increasing adoption for ischemic heart disease patients.
Area of Science:
- Cardiology
- Vascular Physiology
- Diagnostic Imaging
Background:
- Microvascular diseases in coronary circulation are challenging to assess.
- Current methods like wire-derived index of microvascular resistance (IMR) require invasive procedures.
Purpose of the Study:
- To evaluate the diagnostic performance of a novel coronary angiography-derived index of microvascular resistance (caIMR).
- To compare caIMR against the reference standard wire-derived IMR in patients with suspected microvascular dysfunction.
Main Methods:
- Coronary angiography and aortic pressure waves were used to compute caIMR in 56 patients.
- caIMR was assessed against wire-derived IMR (Certus pressure wire) in a blinded manner.
- Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were calculated with a cutoff of 25.
Main Results:
- caIMR demonstrated high diagnostic accuracy (84.2%), sensitivity (86.1%), and specificity (81.0%) compared to IMR.
- A strong correlation (r=0.746) and high AUC (0.919) were observed between caIMR and wire-derived IMR.
- The caIMR method showed potential to eliminate the need for pressure wires.
Conclusions:
- Coronary angiography-derived index of microvascular resistance (caIMR) is a viable, non-invasive tool for assessing coronary microvascular resistance.
- caIMR offers a promising alternative to invasive pressure wire measurements, potentially improving the diagnosis and management of microvascular diseases.
- This technique could enhance the adoption of physiological assessments for patients with ischemic heart disease.
