Universität zu Köln

Milzi, Andrea, Dettori, Rosalia, Lubberich, Richard Karl, Burgmaier, Kathrin, Marx, Nikolaus, Reith, Sebastian and Burgmaier, Mathias (2022). Coronary microvascular dysfunction as assessed by angiography-derived index of microvascular resistance co-localizes with and may explain the presence of ischemia in stress-cardiac magnetic resonance imaging in the absence of coronary artery disease. Front. Cardiovasc. Med., 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2297-055X

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Abstract

IntroductionIschemia with no obstructive coronary disease (INOCA) is a frequent phenomenon in the cath lab. A possible cause is coronary microvascular dysfunction (CMD), which may be assessed by invasive testing with possible complications; therefore, less invasive approaches have emerged, such as the angiography-derived index of microvascular resistance (aIMR). The aim of our study was to investigate the association of single-vessel aIMR as a measure of CMD with areas of INOCA in stress testing. MethodsWe measured aIMR in 286 vessels from 102 patients undergoing both stress cMRI and coronary angiography. Groups were (a) INOCA group (93 vessels, 32 patients); (b) coronary artery disease (CAD) control group (116 vessels, 42 patients) with ischemia due to relevant stenosis; and (c) control group (77 vessels, 28 patients) without ischemia or relevant stenosis. ResultsINOCA patients presented higher mean aIMR (28.3 +/- 5.7) compared to both CAD patients (17.4 +/- 5.7, p < 0.001) and controls (22.1 +/- 5.9, p < 0.001). Furthermore, in INOCA patients aIMR was significantly increased (33.0 +/- 8.1 vs. 25.8 +/- 6.3, p = 0.021) in vessels with vs. without ischemia. Single vessel aIMR presented a very good diagnostic efficiency in detecting INOCA [AUC 0.865 (0.804-0.925), optimal cut-off 27.1, p < 0.001]. ConclusionCMD, as assessed by 3-vessel aIMR, co-localizes with and may explain the presence of ischemia in stress-cMRI in INOCA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Milzi, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Dettori, Rosalia UNSPECIFIED UNSPECIFIED UNSPECIFIED Lubberich, Richard Karl UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679370
DOI:	10.3389/fcvm.2022.1060764
Journal or Publication Title:	Front. Cardiovasc. Med.
Volume:	9
Date:	2022
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2297-055X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67937