Quantitative Flow Ratio-Derived Index of Microcirculatory Resistance as a Novel Tool to Identify Microcirculatory Function in Patients with Ischemia and No Obstructive Coronary Artery Disease

Background: Coronary microvascular disease (CMVD) is associated with adverse cardiovascular outcomes. However, there is no reliable and noninvasive quantitative diagnostic method available for CMVD. The use of a pressure wire to measure the index of microcirculatory resistance (IMR) is possible, but it has inevitable practical restrictions. We hypothesized that computation of the quantitative flow ratio could be used to predict CMVD with symptoms of ischemia and no obstructive coronary artery disease (INOCA). Methods: We retrospectively assessed the diagnostic efficiency of the quantitative flow ratio-derived index of microcirculatory resistance (QMR) in 103 vessels from 66 patients and compared it with invasive IMR using the thermodilution technique. Results: Patients were divided into the CMVD group (41/66, 62.1%) and non-CMVD group (25/66, 37.9%). Pressure wire IMR measurements were made in 103 coronary vessels, including 44 left descending arteries, 18 left circumflex arteries, and 41 right coronary arteries. ROC curve analysis showed a good diagnostic performance of QMR for all arteries (area under the curve = 0.820, 95% confidence interval 0.736–0.904, p < 0.001) in predicting microcirculatory function. The optimal cut-off for QMR to predict microcirculatory function was 266 (sensitivity: 82.9%, specificity: 72.6%, and diagnostic accuracy: 76.7%). Conclusion: QMR is a promising tool for the assessment of coronary microcirculation. The assessment of the IMR without the use of a pressure wire may enable more rapid, convenient, and cost-effective assessment of coronary microvascular function.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Quantitative Flow Ratio-Derived Index of Microcirculatory Resistance as a Novel Tool to Identify Microcirculatory Function in Patients with Ischemia and No Obstructive Coronary Artery Disease ; volume:149 ; number:1 ; year:2024 ; pages:14-22 ; extent:9
Cardiology ; 149, Heft 1 (2024), 14-22 (gesamt 9)

Creator
Gao, Beibei
Wu, Guomin
Xie, Jianchang
Ruan, Jie
Xu, Peng
Qian, Yufeng
Gu, Junjie
Li, Wei
Jin, Xiangbo
Tong, Guoxin
Huang, Jinyu

DOI
10.1159/000534287
URN
urn:nbn:de:101:1-2024021423210331087682
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:37 AM CEST

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Associated

  • Gao, Beibei
  • Wu, Guomin
  • Xie, Jianchang
  • Ruan, Jie
  • Xu, Peng
  • Qian, Yufeng
  • Gu, Junjie
  • Li, Wei
  • Jin, Xiangbo
  • Tong, Guoxin
  • Huang, Jinyu

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