Academic Journal
Integrated physiologic assessment of ischemic heart disease in real-world practice using index of microcirculatory resistance and fractional flow reserve: insights from the International Index of Microcirculatory Resistance Registry.
| العنوان: | Integrated physiologic assessment of ischemic heart disease in real-world practice using index of microcirculatory resistance and fractional flow reserve: insights from the International Index of Microcirculatory Resistance Registry. |
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| المؤلفون: | Stuart Watkins, Mauro Echavarria-Pinto, Andy S. Yong, Joon-Hyung Doh, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo, Martin K. Ng, Joo Myung Lee, Jamie Layland, Ji-Hyun Jung, Hyun-Jung Lee, Javier Escaned, William F. Fearon, Keith G. Oldroyd |
| المساهمون: | 남창욱, Nam, Chang Wook, Dept. of Internal Medicine (내과학) |
| بيانات النشر: | School of Medicine |
| سنة النشر: | 2015 |
| المجموعة: | Keimyung University Medical Library: KUMeL Repository |
| مصطلحات موضوعية: | Coronary artery disease, Fractional flow reserve, Ischemic heart disease, Microcirculation, Physiology |
| الوصف: | Background—The index of microcirculatory resistance (IMR) is a quantitative and specific index for coronary microcirculation. However, the distribution and determinants of IMR have not been fully investigated in patients with ischemic heart disease (IHD). Methods and Results—Consecutive patients who underwent elective measurement of both fractional flow reserve (FFR) and IMR were enrolled from 8 centers in 5 countries. Patients with acute myocardial infarction were excluded. To adjust for the influence of collateral flow, IMR values were corrected with Yong’s formula (IMRcorr). High IMR was defined as greater than the 75th percentile in each of the major coronary arteries. FFR≤0.80 was defined as an ischemic value. 1096 patients with 1452 coronary arteries were analyzed (mean age 61.1, male 71.2%). Mean FFR was 0.84 and median IMRcorr was 16.6 U (Q1, Q3 12.4 U, 23.0 U). There was no correlation between IMRcorr and FFR values (r=0.01, P=0.62), and the categorical agreement of FFR and IMRcorr was low (kappa value=−0.04, P=0.10). There was no correlation between IMRcorr and angiographic % diameter stenosis (r=−0.03, P=0.25). Determinants of high IMR were previous myocardial infarction (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.24–3.74, P=0.01), right coronary artery (OR 2.09, 95% CI 1.54–2.84, P<0.01), female (OR 1.67, 95% CI 1.18–2.38, P<0.01), and obesity (OR 1.80, 95% CI 1.31–2.49, P<0.01). Determinants of FFR ≤0.80 were left anterior descending coronary artery (OR 4.31, 95% CI 2.92–6.36, P<0.01), angiographic diameter stenosis ≥50% (OR 5.16, 95% CI 3.66–7.28, P<0.01), male (OR 2.15, 95% CI 1.38–3.35, P<0.01), and age (per 10 years, OR 1.21, 95% CI 1.01–1.46, P=0.04). Conclusions—IMR showed no correlation with FFR and angiographic lesion severity, and the predictors of high IMR value were different from those for ischemic FFR value. Therefore, integration of IMR into FFR measurement may provide additional insights regarding the relative contribution of macro- and microvascular ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| تدمد: | 1941-7640 |
| Relation: | Circulation: Cardiovascular Interventions., Vol.8(11) : e002857-e002857, 2015; oak-2015-0133; http://kumel.medlib.dsmc.or.kr/handle/2015.oak/32982 |
| DOI: | 10.1161/CIRCINTERVENTIONS.115.002857 |
| الاتاحة: | http://kumel.medlib.dsmc.or.kr/handle/2015.oak/32982 https://doi.org/10.1161/CIRCINTERVENTIONS.115.002857 |
| Rights: | BY_NC_ND ; http://creativecommons.org/licenses/by-nc-nd/2.0/kr |
| رقم الانضمام: | edsbas.77A6F89B |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 19417640 |
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| DOI: | 10.1161/CIRCINTERVENTIONS.115.002857 |