PMID- 32409977
OWN - NLM
STAT- MEDLINE
DCOM- 20201005
LR  - 20211006
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Print)
IS  - 1569-5794 (Linking)
VI  - 36
IP  - 8
DP  - 2020 Aug
TI  - Angiography-derived index of microcirculatory resistance as a novel, 
      pressure-wire-free tool to assess coronary microcirculation in ST elevation 
      myocardial infarction.
PG  - 1395-1406
LID - 10.1007/s10554-020-01831-7 [doi]
AB  - Immediate assessment of coronary microcirculation during treatment of ST 
      elevation myocardial infarction (STEMI) may facilitate patient stratification for 
      targeted treatment algorithms. Use of pressure-wire to measure the index of 
      microcirculatory resistance (IMR) is possible but has inevitable practical 
      restrictions. We aimed to develop and validate angiography-derived index of 
      microcirculatory resistance (IMR(angio)) as a novel and pressure-wire-free index 
      to facilitate assessment of the coronary microcirculation. 45 STEMI patients 
      treated with primary percutaneous coronary intervention (pPCI) were enrolled. 
      Immediately before stenting and at completion of pPCI, IMR was measured within 
      the infarct related artery (IRA). At the same time points, 2 angiographic views 
      were acquired during hyperaemia to measure quantitative flow ratio (QFR) from 
      which IMR(angio) was derived. In a subset of 15 patients both IMR and IMR(angio) 
      were also measured in the non-IRA. Patients underwent cardiovascular magnetic 
      resonance imaging (CMR) at 48 h for assessment of microvascular obstruction 
      (MVO). IMR(angio) and IMR were significantly correlated (rho: 0.85, p < 0.001). 
      Both IMR and IMR(angio) were higher in the IRA rather than in the non-IRA 
      (p = 0.01 and p = 0.006, respectively) and were higher in patients with evidence 
      of clinically significant MVO (> 1.55% of left ventricular mass) (p = 0.03 and 
      p = 0.005, respectively). Post-pPCI IMR(angio) presented and area under the curve 
      (AUC) of 0.96 (CI95% 0.92-1.00, p < 0.001) for prediction of post-pPCI IMR > 40U 
      and of 0.81 (CI95% 0.65-0.97, p < 0.001) for MVO > 1.55%. IMR(angio) is a 
      promising tool for the assessment of coronary microcirculation. Assessment of IMR 
      without the use of a pressure-wire may enable more rapid, convenient and 
      cost-effective assessment of coronary microvascular function.
FAU - De Maria, Giovanni Luigi
AU  - De Maria GL
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Scarsini, Roberto
AU  - Scarsini R
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Shanmuganathan, Mayooran
AU  - Shanmuganathan M
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
AD  - Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of 
      Oxford, Oxford, UK.
FAU - Kotronias, Rafail A
AU  - Kotronias RA
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Terentes-Printzios, Dimitrios
AU  - Terentes-Printzios D
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Borlotti, Alessandra
AU  - Borlotti A
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Langrish, Jeremy P
AU  - Langrish JP
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Lucking, Andrew J
AU  - Lucking AJ
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Choudhury, Robin P
AU  - Choudhury RP
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Kharbanda, Rajesh
AU  - Kharbanda R
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Ferreira, Vanessa M
AU  - Ferreira VM
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
AD  - Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of 
      Oxford, Oxford, UK.
CN  - Oxford Acute Myocardial Infarction (OXAMI) Study Investigators
FAU - Channon, Keith M
AU  - Channon KM
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK.
FAU - Garcia-Garcia, Hector M
AU  - Garcia-Garcia HM
AD  - MedStar Washington Hospital Center, Washington, DC, USA.
FAU - Banning, Adrian P
AU  - Banning AP
AD  - Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University 
      Hospitals, Headley Way, Oxford, OX39DU, UK. adrian.banning@ouh.nhs.uk.
LA  - eng
GR  - CH/16/1/32013/BHF_/British Heart Foundation/United Kingdom
GR  - RG/13/1/30181/BHF Centre of Research Excellence, Oxford (GB)/
PT  - Comparative Study
PT  - Journal Article
PT  - Validation Study
DEP - 20200514
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/instrumentation
MH  - Blood Flow Velocity
MH  - Cardiac Catheterization/instrumentation
MH  - Cardiac Catheters
MH  - *Coronary Angiography
MH  - Coronary Artery Disease/*diagnostic imaging/physiopathology/therapy
MH  - *Coronary Circulation
MH  - Coronary Vessels/*diagnostic imaging/physiopathology
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - *Microcirculation
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Radiographic Image Interpretation, Computer-Assisted
MH  - Reproducibility of Results
MH  - ST Elevation Myocardial Infarction/*diagnostic imaging/physiopathology/therapy
MH  - Stents
MH  - Transducers, Pressure
MH  - *Vascular Resistance
PMC - PMC7381481
OTO - NOTNLM
OT  - Index of microcirculatory resistance
OT  - Microvascular dysfunction
OT  - Microvascular obstruction
OT  - Quantitative flow ratio
OT  - STEMI
COIS- All authors declare that they have no conflict of interest to disclose.
EDAT- 2020/05/16 06:00
MHDA- 2020/10/06 06:00
PMCR- 2020/05/14
CRDT- 2020/05/16 06:00
PHST- 2020/01/20 00:00 [received]
PHST- 2020/03/28 00:00 [accepted]
PHST- 2020/05/16 06:00 [pubmed]
PHST- 2020/10/06 06:00 [medline]
PHST- 2020/05/16 06:00 [entrez]
PHST- 2020/05/14 00:00 [pmc-release]
AID - 10.1007/s10554-020-01831-7 [pii]
AID - 1831 [pii]
AID - 10.1007/s10554-020-01831-7 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2020 Aug;36(8):1395-1406. doi: 
      10.1007/s10554-020-01831-7. Epub 2020 May 14.