Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients
Abstract Background Angio-based microvascular resistance (AMR) was proposed as a tool to quantitatively assess coronary microvascular based on single angiographic projection. The aims of this study are to assess the diagnostic accuracy and prognostic significance of AMR in ST-segment elevation myoca...
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BMC
2025-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04796-4 |
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| author | Zhe Zhang Qing Dai Xinlin Zhang Shiyang Qiao Xue Bao Kun Wang Peng Xue Yuan Gao Xuemei Guo Yanan Xue Zhonghai Wei Biao Xu Lina Kang |
| author_facet | Zhe Zhang Qing Dai Xinlin Zhang Shiyang Qiao Xue Bao Kun Wang Peng Xue Yuan Gao Xuemei Guo Yanan Xue Zhonghai Wei Biao Xu Lina Kang |
| author_sort | Zhe Zhang |
| collection | DOAJ |
| description | Abstract Background Angio-based microvascular resistance (AMR) was proposed as a tool to quantitatively assess coronary microvascular based on single angiographic projection. The aims of this study are to assess the diagnostic accuracy and prognostic significance of AMR in ST-segment elevation myocardial infarction (STEMI) patients. Methods AMR was measured (Of these, 22 patients measured index of microvascular resistance (IMR)) in 70 STEMI patients after primary percutaneous coronary intervention (pPCI). ST-segment resolution (STR) was assessed 2 h after pPCI simultaneously. Transthoracic echocardiography was performed within 1 day and approximately 1 year after pPCI. STEMI patients underwent pPCI were followed up for 7.3 years and the primary endpoint was the major adverse cardiac and cerebral events (MACCEs). Results AMR showed significant correlations with IMR (R = 0.334, P = 0.005). AMR has good predictive power for STR after pPCI (area under the curve: 0.889, sensitivity: 94.59%, specificity: 75.76%) in receiver operating characteristic (ROC) curve. Low-AMR patients showed markedly improved left ventricular ejection fraction (LVEF) 1 year after pPCI (42(40–49) vs. 41(39–44), P = 0.041). High-AMR patients showed higher risk for MACCEs than those with Low-AMR (HR = 3.90, P = 0.02). In multivariate cox regression analysis, AMR was considered an independent predictor of MACCEs (HR: 1.153, P = 0.020). Conclusions AMR is a reliable tool for the estimation of microvascular resistance and prognosis in the absence of intracoronary pressure-temperature sensor wire and adenosine based on single angiographic projection. |
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| institution | OA Journals |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-8a0f1da2fa274e269584c94b6fc6f1972025-08-20T01:49:39ZengBMCBMC Cardiovascular Disorders1471-22612025-05-0125111210.1186/s12872-025-04796-4Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patientsZhe Zhang0Qing Dai1Xinlin Zhang2Shiyang Qiao3Xue Bao4Kun Wang5Peng Xue6Yuan Gao7Xuemei Guo8Yanan Xue9Zhonghai Wei10Biao Xu11Lina Kang12Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityDepartment of Cardiology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityDepartment of Cardiology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityAbstract Background Angio-based microvascular resistance (AMR) was proposed as a tool to quantitatively assess coronary microvascular based on single angiographic projection. The aims of this study are to assess the diagnostic accuracy and prognostic significance of AMR in ST-segment elevation myocardial infarction (STEMI) patients. Methods AMR was measured (Of these, 22 patients measured index of microvascular resistance (IMR)) in 70 STEMI patients after primary percutaneous coronary intervention (pPCI). ST-segment resolution (STR) was assessed 2 h after pPCI simultaneously. Transthoracic echocardiography was performed within 1 day and approximately 1 year after pPCI. STEMI patients underwent pPCI were followed up for 7.3 years and the primary endpoint was the major adverse cardiac and cerebral events (MACCEs). Results AMR showed significant correlations with IMR (R = 0.334, P = 0.005). AMR has good predictive power for STR after pPCI (area under the curve: 0.889, sensitivity: 94.59%, specificity: 75.76%) in receiver operating characteristic (ROC) curve. Low-AMR patients showed markedly improved left ventricular ejection fraction (LVEF) 1 year after pPCI (42(40–49) vs. 41(39–44), P = 0.041). High-AMR patients showed higher risk for MACCEs than those with Low-AMR (HR = 3.90, P = 0.02). In multivariate cox regression analysis, AMR was considered an independent predictor of MACCEs (HR: 1.153, P = 0.020). Conclusions AMR is a reliable tool for the estimation of microvascular resistance and prognosis in the absence of intracoronary pressure-temperature sensor wire and adenosine based on single angiographic projection.https://doi.org/10.1186/s12872-025-04796-4ST-segment elevation myocardial infarctionMyocardial microcirculationCoronary microvascular dysfunctionAngio-based microvascular resistanceMajor adverse cardiac and cerebral events |
| spellingShingle | Zhe Zhang Qing Dai Xinlin Zhang Shiyang Qiao Xue Bao Kun Wang Peng Xue Yuan Gao Xuemei Guo Yanan Xue Zhonghai Wei Biao Xu Lina Kang Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients BMC Cardiovascular Disorders ST-segment elevation myocardial infarction Myocardial microcirculation Coronary microvascular dysfunction Angio-based microvascular resistance Major adverse cardiac and cerebral events |
| title | Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients |
| title_full | Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients |
| title_fullStr | Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients |
| title_full_unstemmed | Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients |
| title_short | Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients |
| title_sort | microcirculatory resistance based on a single angiographic view in st segment elevation myocardial infarction patients |
| topic | ST-segment elevation myocardial infarction Myocardial microcirculation Coronary microvascular dysfunction Angio-based microvascular resistance Major adverse cardiac and cerebral events |
| url | https://doi.org/10.1186/s12872-025-04796-4 |
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