Related Experiment Video

Updated: Jan 25, 2026

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo
05:14

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo

Published on: May 16, 2020

5.3K

Prognostic Value of Angiography-Derived Microcirculatory Resistance and Vericiguat Therapy in Dilated Cardiomyopathy

Chaofan Wang1, Mengxin Shao1, Shuping Yang2

  • 1Department of Cardiology, Affliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

The Canadian Journal of Cardiology
|January 23, 2026
PubMed

Insights

Angiography-derived microcirculatory resistance (AMR) effectively predicts poor prognosis in patients with heart failure with reduced ejection fraction (DCMrEF). Elevated AMR identifies patients who may benefit from vericiguat treatment.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Coronary microvascular dysfunction (CMD) is linked to adverse outcomes in patients with dilated cardiomyopathy with reduced ejection fraction (DCMrEF).
  • Assessing CMD in routine clinical practice presents significant challenges.
  • This study investigates Angiography-derived microcirculatory resistance (AMR) as a prognostic tool in DCMrEF.

Purpose of the Study:

  • To evaluate the predictive value of AMR for clinical outcomes in DCMrEF patients.
  • To determine the prognostic significance of AMR in major coronary arteries.
  • To explore the impact of vericiguat treatment based on baseline AMR levels.

Main Methods:

  • A multicenter retrospective study of 531 DCMrEF patients (2019-2024) with a 5-year Major Adverse Cardiovascular Events (MACE) endpoint.
  • Calculation of AMR for all major coronary arteries.
  • Prognostic assessment using Kaplan-Meier analysis, multivariate Cox regression, and subgroup analysis for vericiguat treatment.

Main Results:

  • Optimal AMR cutoffs identified for LAD, LCX, and RCA arteries (all P < 0.001).
  • Higher AMR was independently associated with increased MACE risk.
  • Left anterior descending artery AMR (LAD-AMR) significantly improved risk reclassification; vericiguat showed benefit primarily in patients with elevated AMR.

Conclusions:

  • AMR serves as a potent independent predictor of poor prognosis in DCMrEF.
  • LAD-AMR demonstrates promising predictive capability.
  • Vericiguat may offer a precision-targeted therapy for heart failure driven by microcirculatory dysfunction.
Abstract

Keywords:
angiographic microvascular resistancecoronary microvascular dysfunctionhigh-sensitivity C-reactive proteinvericiguat

More Related Videos

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

7.0K
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs07:09

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs

Published on: February 18, 2022

2.3K

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
509
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
451
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
496
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
370
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
545
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
332