In Vivo Validation of a Novel Computational Approach to Assess Microcirculatory Resistance Based on a Single Angiographic View

被引:48
作者
Fan, Yongzhen [1 ,2 ]
Fezzi, Simone [3 ,4 ]
Sun, Pengcheng [5 ]
Ding, Nan [5 ]
Li, Xiaohui [5 ]
Hu, Xiaorong [1 ,2 ]
Wang, Shuang [6 ]
Wijns, William [3 ]
Lu, Zhibing [1 ,2 ]
Tu, Shengxian [7 ]
机构
[1] Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan 430071, Peoples R China
[2] Wuhan Univ, Inst Myocardial Injury & Repair, Wuhan 430072, Peoples R China
[3] Univ Galway, Lambe Inst Translat Med, Smart Sensors Lab & Curam, Univ Rd, Galway H91 TK3, Ireland
[4] Univ Verona, Dept Med, Div Cardiol, I-37129 Verona, Italy
[5] Shanghai Pulse Med Technol Inc, Shanghai 200233, Peoples R China
[6] Wuhan Univ, Zhongnan Hosp, Dept Cardiovasc Ultrasound, Wuhan 430071, Peoples R China
[7] Shanghai Jiao Tong Univ, Biomed Instrument Inst, Sch Biomed Engn, Shanghai 200240, Peoples R China
来源
JOURNAL OF PERSONALIZED MEDICINE | 2022年 / 12卷 / 11期
基金
爱尔兰科学基金会;
关键词
coronary physiology; coronary pressure and flow; myocardial microcirculation; microvascular dysfunction; ischemia with non-obstructed coronary artery disease; angiography-derived physiology; functional coronary angiography; personalized invasive therapy in coronary artery disease; CORONARY MICROVASCULAR DYSFUNCTION; QUANTITATIVE FLOW RATIO; ACUTE MYOCARDIAL-INFARCTION; DIAGNOSTIC-ACCURACY; STENOSIS SEVERITY; EUROPEAN-SOCIETY; INDEX; RESERVE;
D O I
10.3390/jpm12111798
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
(1) Background: In spite of the undeniable clinical value of the index of microvascular resistance (IMR) in assessing the status of coronary microcirculation, its use globally remains very low. The aim of this study was to validate the novel single-view, pressure-wire- and adenosine-free angiographic microvascular resistance (AMR) index, having the invasive wire-based IMR as a reference standard. (2) Methods: one hundred and sixty-three patients (257 vessels) were investigated with pressure wire-based IMR. Microvascular dysfunction (CMD) was defined by IMR >= 25. AMR was independently computed from the diagnostic coronary angiography in a blinded fashion. (3) Results: AMR demonstrated a good correlation (r = 0.83, p < 0.001) and diagnostic performance (AUC 0.94; 95% CI: 0.91 to 0.97) compared with wire-based IMR. The best cutoff value for AMR in determining IMR >= 25 was 2.5 mmHg*s/cm. The overall diagnostic accuracy of AMR was 87.2% (95% CI: 83.0% to 91.3%), with a sensitivity of 93.5% (95% CI: 87.0% to 97.3%), a specificity of 82.7% (95% CI: 75.6% to 88.4%), a positive predictive value of 79.4% (95% CI: 71.2% to 86.1%) and a negative predictive value of 94.7% (95% CI: 89.3% to 97.8%). No difference in terms of CMD rate was described among different clinical presentations. (4) Conclusions: AMR derived solely from a single angiographic view is a feasible computational alternative to pressure wire-based IMR, with good diagnostic accuracy in assessing CMD.
引用
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页数:13
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共 36 条
  • [1] Angiography-derived index of microvascular resistance in takotsubo syndrome
    Castaldi, Gianluca
    Fezzi, Simone
    Widmann, Maddalena
    Lia, Micaela
    Rizzetto, Francesca
    Mammone, Concetta
    Pazzi, Sara
    Piccolo, Solange
    Galli, Verdiana
    Pighi, Michele
    Pesarini, Gabriele
    Prati, Daniele
    Ferrero, Valeria
    Scarsini, Roberto
    Tavella, Domenico
    Ribichini, Flavio
    [J]. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2023, 39 (01) : 233 - 244
  • [2] Cortés C, 2021, CATHETER CARDIO INTE, V97, P807, DOI [10.33255/3161/783, 10.1002/ccd.28857]
  • [3] Angiography-derived index of microcirculatory resistance as a novel, pressure-wire-free tool to assess coronary microcirculation in ST elevation myocardial infarction
    De Maria, Giovanni Luigi
    Scarsini, Roberto
    Shanmuganathan, Mayooran
    Kotronias, Rafail A.
    DimitriosTerentes-Printzios
    Borlotti, Alessandra
    Langrish, Jeremy P.
    Lucking, Andrew J.
    Choudhury, Robin P.
    Kharbanda, Rajesh
    Ferreira, Vanessa M.
    Channon, Keith M.
    Garcia-Garcia, Hector M.
    Banning, Adrian P.
    [J]. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2020, 36 (08) : 1395 - 1406
  • [4] Comparison of Doppler Flow Velocity and Thermodilution Derived Indexes of Coronary Physiology
    Demir, Ozan M.
    Boerhout, Coen K. M.
    de Waard, Guus A.
    van de Hoef, Tim P.
    Patel, Niket
    Beijk, Marcel A. M.
    Williams, Rupert
    Rahman, Haseeb
    Everaars, Henk
    Kharbanda, Rajesh K.
    Knaapen, Paul
    van Royen, Niels
    Piek, Jan J.
    Perera, Divaka
    [J]. JACC-CARDIOVASCULAR INTERVENTIONS, 2022, 15 (10) : 1060 - 1070
  • [5] Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve A Head-to-Head Comparison With [15O]H2O PET
    Everaars, Henk
    de Waard, Guus A.
    Driessen, Roel S.
    Danad, Ibrahim
    van de Ven, Peter M.
    Raijmakers, Pieter G.
    Lammertsma, Adriaan A.
    van Rossum, Albert C.
    Knaapen, Paul
    van Royen, Niels
    [J]. JACC-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (20) : 2044 - 2054
  • [6] Microvascular resistance is not influenced by epicardial coronary artery stenosis severity - Experimental validation
    Fearon, WF
    Aarnoudse, W
    Pijls, NHJ
    De Bruyne, B
    Balsam, LB
    Cooke, DT
    Robbins, RC
    Fitzgerald, PJ
    Yeung, AC
    Yock, PG
    [J]. CIRCULATION, 2004, 109 (19) : 2269 - 2272
  • [7] Novel index for invasively assessing the coronary microcirculation
    Fearon, WF
    Balsam, LB
    Farouque, HMO
    Robbins, RC
    Fitzgerald, PJ
    Yock, PG
    Yeung, AC
    [J]. CIRCULATION, 2003, 107 (25) : 3129 - 3132
  • [8] Invasive Assessment of the Coronary Microvasculature The Index of Microcirculatory Resistance
    Fearon, William F.
    Kobayashi, Yuhei
    [J]. CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2017, 10 (12)
  • [9] Angiotensin-Converting Enzyme Inhibition Early After Heart Transplantation
    Fearon, William F.
    Okada, Kozo
    Kobashigawa, Jon A.
    Kobayashi, Yuhei
    Luikart, Helen
    Sana, Sean
    Daun, Tiffany
    Chmura, Steven A.
    Sinha, Seema
    Cohen, Garett
    Honda, Yasuhiro
    Pham, Michael
    Lewis, David B.
    Bernstein, Daniel
    Yeung, Alan C.
    Valantine, Hannah A.
    Khush, Kiran
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2017, 69 (23) : 2832 - 2841
  • [10] Angiography-derived versus invasively-determined index of microcirculatory resistance in the assessment of coronary microcirculation: A systematic review and meta-analysis
    Fernandez-Peregrina, Estefania
    Garcia-Garcia, Hector M.
    Sans-Rosello, Jordi
    Sanz-Sanchez, Jorge
    Kotronias, Rafail
    Scarsini, Roberto
    Echavarria-Pinto, Mauro
    Tebaldi, Matteo
    De Maria, Giovanni L.
    [J]. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2022, 99 (07) : 2018 - 2025