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

IF 2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

BMC Cardiovascular Disorders Pub Date : 2025-05-09 DOI:10.1186/s12872-025-04796-4

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

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引用次数: 0

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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st段抬高型心肌梗死患者单侧血管造影微循环阻力分析。

背景：基于血管的微血管阻力（AMR）被提出作为基于单次血管造影投影定量评估冠状动脉微血管的工具。本研究的目的是评估AMR在st段抬高型心肌梗死（STEMI）患者中的诊断准确性和预后意义。方法：测定70例STEMI患者经皮冠状动脉介入治疗（pPCI）后的微血管阻力指数（IMR）（其中22例）。pPCI后2 h同时评估st段分辨率（STR）。在pPCI后1天和大约1年内进行经胸超声心动图检查。STEMI患者接受pPCI随访7.3年，主要终点为主要心脏和大脑不良事件（MACCEs）。结果：AMR与IMR呈显著相关（R = 0.334, P = 0.005）。在受试者工作特征（ROC）曲线上，AMR对pPCI后STR有较好的预测能力（曲线下面积：0.889，灵敏度：94.59%，特异性：75.76%）。低amr患者在pPCI后1年左室射血分数（LVEF）明显改善(42（40-49)vs. 41(39-44), P = 0.041）。高amr患者发生MACCEs的风险高于低amr患者（HR = 3.90, P = 0.02）。在多变量cox回归分析中，AMR被认为是MACCEs的独立预测因子（HR: 1.153, P = 0.020）。结论：在没有冠状动脉内压力-温度传感器线和腺苷的情况下，AMR是评估微血管阻力和预后的可靠工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Cardiovascular Disorders CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.50

自引率

0.00%

发文量

480

审稿时长

1 months

期刊介绍： BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.