Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance

Gutiérrez-Barrios, Alejandro; Camacho-Jurado, Francisco; Díaz‐Retamino, Enrique; Gamaza-Chulián, Sergio; Agarrado-Luna, Antonio; Oneto-Otero, Jesús; Rio-Lechuga, Ana del; Benezet-Mazuecos, Javier

doi:10.1016/j.carrev.2015.06.008

Cited by 13 publications

(4 citation statements)

References 26 publications

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“…However, the use of this index to assess microcirculation in HCM is not common. A case was reported of a symptomatic HCM patient with inducible ischemia detected by SPECT, normal epicardial arteries, and an elevated IMR value of 39 U, demonstrating microvascular dysfunction (normal IMR < 27.2 U) 75 . This suggests that IMR can be used in these patients for microcirculation assessment.…”

Section: Assessment Of Coronary Microvascular Dysfunction In Hcmmentioning

confidence: 99%

Coronary microvascular dysfunction in hypertrophic cardiomyopathy: Pathophysiology, assessment, and clinical impact

et al. 2020

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Myocardial ischemia constitutes one of the most important pathophysiological features in hypertrophic cardiomyopathy. Chronic and recurrent myocardial ischemia leads to fibrosis, which may culminate in myocardial dysfunction. Since the direct visualization of coronary microcirculation in vivo is not possible, its function must be studied indirectly. Invasive and noninvasive techniques allow microcirculatory dysfunction to be evaluated, including echocardiography, magnetic resonance, positron emission tomography, and cardiac catheterization. Blunted myocardial blood flow and coronary flow reserve have been suggested to associate with unfavorable prognosis. Microcirculatory dysfunction may be one additional important parameter to take into account for risk stratification beyond the conventional risk factors.

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Section: Assessment Of Coronary Microvascular Dysfunction In Hcmmentioning

confidence: 99%

Coronary microvascular dysfunction in hypertrophic cardiomyopathy: Pathophysiology, assessment, and clinical impact

et al. 2020

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“…21 There are several invasive or noninvasive methods for evaluating microcirculation. [22][23][24] Compared with other methods, MRI can evaluate morphology, function, hemodynamics, and tissue characteristics in a single study. Among various MRI sequences, IVIM has unique diagnostic value, reflecting the diffusion and perfusion information of water molecular motion between myocyte, microcirculation and vascular flow in vivo tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Quantitative and accurate assessment of microvascular dysfunction is of importance for risk stratification and decision‐making in HCM patients 21 . There are several invasive or noninvasive methods for evaluating microcirculation 22–24 . Compared with other methods, MRI can evaluate morphology, function, hemodynamics, and tissue characteristics in a single study.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Dysfunction Associates With Outcomes in Hypertrophic Cardiomyopathy: Insights From the Intravoxel Incoherent MotionMRI

Xiang

Lin

Zhang

et al. 2022

Magnetic Resonance Imaging

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Background Although intravoxel incoherent motion (IVIM) MRI has emerged as an in vivo marker of tissue diffusion and perfusion, its prognostic value in patients with hypertrophic cardiomyopathy (HCM) remains unclear. Purpose To investigate whether IVIM‐MRI derived parameters are associated with outcomes in patients with HCM. Study Type Prospective cohort. Subjects A total of 112 patients (51.72 ± 17.13 years) with suspected or known HCM. Field Strength/Sequence Single‐shot echo planar IVIM imaging, balanced steady‐state free precession, and phase‐sensitive inversion‐recovery late gadolinium enhancement (LGE) sequences at 3 T. Assessment All patients were followed up of 29.3 ± 12.3 months for combined major adverse cardiac events (MACE) including cardiac death, aborted sudden death, heart transplantation, and rehospitalization for heart failure. The CVI42 imaging platform was used to assess morphological and functional MRI indices and to quantify LGE. The Body Diffusion Toolbox was used to derive pseudo diffusion (D*), water molecular diffusion (D) and perfusion fraction (f). Statistical Tests Univariable and stepwise multivariable Cox model analyses were used to investigate the association between variables and composite endpoints. Kaplan–Meier curves were constructed to assess event‐free survival, and the event rates were compared by the log‐rank test. Results A total of 19 patients reached endpoints. Patients with MACE showed a significantly impaired D* value, lower f value, and more extensive LGE than those without MACE (all, P < 0.05), while there was no significant difference in D value (P = 0.285). In the Cox regression models, D* value (hazard ratio [HR] 0.93; 95% CI: 0.88–0.98) and f value (HR 0.65; 95% CI: 0.45–0.92) were independent predictors for MACE. Moreover, in Kaplan–Meier survival analysis, the incidence of MACE was significantly higher in patients with decreased D* value and f value. Conclusions Impaired D* and f values derived from IVIM‐MRI are associated with adverse outcomes in patients with HCM. Level of Evidence 2 Technical Efficacy Stage 2

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“…The pathophysiological mechanism of CMD is still unclear. Although CMD has a good long-term prognosis, patients with chest pain have a relatively high mortality [ 2 ] . In addition, patients with CMD may present with ST segment depression on an electrocardiogram, but have normal or almost normal coronary arteries on angiography [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Left Ventricular Systolic Function in Patients with Coronary Microvascular Dysfunction by Three-Dimensional Speckle-Tracking Imaging

Yu¹,

Pan²,

Cheng³

et al. 2022

Braz J Cardiovasc Surg

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Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance

Cited by 13 publications

References 26 publications

Coronary microvascular dysfunction in hypertrophic cardiomyopathy: Pathophysiology, assessment, and clinical impact

Coronary microvascular dysfunction in hypertrophic cardiomyopathy: Pathophysiology, assessment, and clinical impact

Microvascular Dysfunction Associates With Outcomes in Hypertrophic Cardiomyopathy: Insights From the Intravoxel Incoherent MotionMRI

Evaluation of Left Ventricular Systolic Function in Patients with Coronary Microvascular Dysfunction by Three-Dimensional Speckle-Tracking Imaging

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