1. Doppler Versus Thermodilution-Derived Coronary Microvascular Resistance to Predict Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction or Stable Angina Pectoris
- Author
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Williams, RP, Waard, GD, Silva, KD, Lumley, M, Asrress, K, Arri, S, Ellis, H, Mir, A, Clapp, B, Chiribiri, A, Plein, S, Teunissen, P, Hollander, M, Marber, M, Redwood, S, Royen, NV, Perera, D, Cardiology, ACS - Atherosclerosis & ischemic syndromes, Division 6, and ACS - Heart failure & arrhythmias
- Subjects
Male ,Cardiac Catheterization ,Microcirculation ,Thermodilution ,Myocardial Infarction ,Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] ,hyperemic microvascular resistance (hMR) ,Hyperemia ,Middle Aged ,Sensitivity and Specificity ,Article ,Echocardiography, Doppler ,Coronary microvascular resistance ,myocardial infarction ,index of microcirculatory resistance (IMR) ,Coronary Circulation ,Humans ,Female ,Vascular Resistance ,Angina, Stable ,Cardiac Output ,Blood Flow Velocity ,Aged - Abstract
Contains fulltext : 184154.pdf (Publisher’s version ) (Open Access) Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there is no accepted gold-standard measurement. We compared the diagnostic accuracy of 2 invasive indices of microvascular resistance, Doppler-derived hyperemic microvascular resistance (hMR) and thermodilution-derived index of microcirculatory resistance (IMR), at predicting microvascular dysfunction. A total of 54 patients (61 +/- 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction (n = 44) had simultaneous intracoronary pressure, Doppler flow velocity and thermodilution flow data acquired from 74 unobstructed vessels, at rest and during hyperemia. Three independent measurements of microvascular function were assessed, using predefined dichotomous thresholds: (1) coronary flow reserve (CFR), the average value of Doppler- and thermodilution-derived CFR; (2) cardiovascular magnetic resonance (CMR) derived myocardial perfusion reserve index; and (3) CMR-derived microvascular obstruction. hMR correlated with IMR (rho = 0.41, p
- Published
- 2018