Impact of sex on the assessment of the microvascular resistance reserve

Area of Science:

• Cardiovascular Medicine
• Coronary Artery Disease Research
• Hemodynamics

Background:

• Microvascular resistance reserve (MRR) assesses coronary vasodilatory capacity, accounting for epicardial disease.
• MRR is a valuable diagnostic and prognostic tool in general coronary artery disease (CAD) populations.
• Specific considerations for MRR assessment in women are needed due to unique hemodynamic characteristics.

Purpose of the Study:

• To evaluate the diagnostic and prognostic applicability of MRR in women.
• To compare the diagnostic and prognostic value of MRR between sexes.

Main Methods:

• Analysis of data from the ILIAS Registry including patients with stable coronary artery disease.
• Inclusion of patients with complete physiological and follow-up data.
• Comparison of MRR diagnostic and prognostic values between women and men.

Main Results:

• A good correlation between MRR and coronary flow reserve (CFR) was observed in both women (r=0.80) and men (r=0.81).
• MRR independently predicted major adverse cardiovascular events (MACE) in both women (HR 0.67) and men (HR 0.84).
• Optimal MRR cut-off values were 2.8 for women and 3.2 for men, with abnormal MRR predicting MACE at 5-year follow-up in both groups.

Conclusions:

• MRR demonstrates equal applicability in assessing stable coronary artery disease in both women and men.
• The diagnostic and prognostic utility of MRR is consistent across sexes.
• MRR is a reliable index for evaluating coronary microvascular function in both male and female patients.