Microvascular Resistance Reserve for Assessment of Coronary Microvascular Function: JACC Technology Corner.

Details

Serval ID
serval:BIB_CC122079262E
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Microvascular Resistance Reserve for Assessment of Coronary Microvascular Function: JACC Technology Corner.
Journal
Journal of the American College of Cardiology
Author(s)
De Bruyne B., Pijls NHJ, Gallinoro E., Candreva A., Fournier S., Keulards DCJ, Sonck J., Van't Veer M., Barbato E., Bartunek J., Vanderheyden M., Wyffels E., De Vos A., El Farissi M., Tonino PAL, Muller O., Collet C., Fearon W.F.
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Publication state
Published
Issued date
12/10/2021
Peer-reviewed
Oui
Volume
78
Number
15
Pages
1541-1549
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
The need for a quantitative and operator-independent assessment of coronary microvascular function is increasingly recognized. We propose the theoretical framework of microvascular resistance reserve (MRR) as an index specific for the microvasculature, independent of autoregulation and myocardial mass, and based on operator-independent measurements of absolute values of coronary flow and pressure. In its general form, MRR equals coronary flow reserve (CFR) divided by fractional flow reserve (FFR) corrected for driving pressures. In 30 arteries, pressure, temperature, and flow velocity measurements were obtained simultaneously at baseline (BL), during infusion of saline at 10 mL/min (rest) and 20 mL/min (hyperemia). A strong correlation was found between continuous thermodilution-derived MRR and Doppler MRR (r = 0.88; 95% confidence interval: 0.72-0.93; P < 0.001). MRR was independent from the epicardial resistance, the lower the FFR value, the greater the difference between MRR and CFR. Therefore, MRR is proposed as a specific, quantitative, and operator-independent metric to quantify coronary microvascular dysfunction.
Keywords
absolute coronary flow, coronary flow reserve, fractional flow reserve, microvascular dysfunction, microvascular resistance
Pubmed
Web of science
Create date
13/10/2021 15:57
Last modification date
23/10/2021 6:38
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