2022
DOI: 10.3390/jpm12111798
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In Vivo Validation of a Novel Computational Approach to Assess Microcirculatory Resistance Based on a Single Angiographic View

Abstract: (1) Background: In spite of the undeniable clinical value of the index of microvascular resistance (IMR) in assessing the status of coronary microcirculation, its use globally remains very low. The aim of this study was to validate the novel single-view, pressure-wire- and adenosine-free angiographic microvascular resistance (AMR) index, having the invasive wire-based IMR as a reference standard. (2) Methods: one hundred and sixty-three patients (257 vessels) were investigated with pressure wire-based IMR. Mic… Show more

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Cited by 32 publications
(38 citation statements)
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“…AMR is a novel index that was validated both in chronic and acute coronary syndromes, showing a good diagnostic accuracy (87.2% [95% CI, 83.0%–91.3%]) comparable to our report. 17 Of note, AMR computation allows to overcome some potential drawbacks of previously proposed angiography-derived IMR indexes 28 : in particular, AMR computation is not influenced by the length of the region of interest chosen, as it is based on the estimated hyperemic flow velocity instead of the mean transit time. Conversely, with the use of mean contrast transit time, the longer the segment of interest, the higher the mean contrast transit time and thus the higher the angiography-derived IMR.…”
Section: Discussionmentioning
confidence: 99%
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“…AMR is a novel index that was validated both in chronic and acute coronary syndromes, showing a good diagnostic accuracy (87.2% [95% CI, 83.0%–91.3%]) comparable to our report. 17 Of note, AMR computation allows to overcome some potential drawbacks of previously proposed angiography-derived IMR indexes 28 : in particular, AMR computation is not influenced by the length of the region of interest chosen, as it is based on the estimated hyperemic flow velocity instead of the mean transit time. Conversely, with the use of mean contrast transit time, the longer the segment of interest, the higher the mean contrast transit time and thus the higher the angiography-derived IMR.…”
Section: Discussionmentioning
confidence: 99%
“…The detailed methodology for single-view μQFR and angiography microvascular resistance (AMR) computation has been described previously 10,17 and reported in Supplemental Material.…”
Section: Analysis Of μQfr and Angiographic Microvascular Resistancementioning
confidence: 99%
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“…Analysis was performed by an experienced analyst who was blinded to the follow‐up data. The detailed method for single‐view QFR and AMR computation has been reported in previous studies 11,14 . Briefly, the contrast medium was manually injected with a forceful and stable injection or by a pump at a rate of approximately 4 mL/s.…”
Section: Methodsmentioning
confidence: 99%
“…Indeed, QFR eliminates the requirement of pressure guidewires and is a suitable strategy for assessing coronary ischemia 6 . Moreover, a guidewire‐free and adenosine‐free angiography‐derived microcirculatory resistance (AMR) derived from QFR with flow velocity calculation exhibits good diagnostic accuracy for assessing CMD; therefore, it can be an effective clinical alternative to invasive pressure guidewire‐based IMR 11 …”
Section: Introductionmentioning
confidence: 99%