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Background <p>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.</p> Methods <p>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&#xa0;h after pPCI simultaneously. Transthoracic echocardiography was performed within 1&#xa0;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).</p> Results <p>AMR showed significant correlations with IMR (<i>R</i> = 0.334, <i>P</i> = 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), <i>P</i> = 0.041). High-AMR patients showed higher risk for MACCEs than those with Low-AMR (HR = 3.90, <i>P</i> = 0.02). In multivariate cox regression analysis, AMR was considered an independent predictor of MACCEs (HR: 1.153, <i>P</i> = 0.020).</p> Conclusions <p>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.</p>

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Microcirculatory resistance based on a single angiographic view in ST-segment elevation myocardial infarction patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月9日

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  • 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

摘要

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.