Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4383 |
Resumo: | Introduction and objectives: Coronary microvascular dysfunction (CMD) is one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). The index of microcirculatory resistance (IMR) is an invasive method to assess the coronary microcirculation. The aim was to assess CMD in patients with HCM by IMR. Methods: Adult patients with HCM without epicardial coronary artery disease underwent cardiac catheterization for the assessment of CMD by IMR (normal cut-off value ≤22.0) and coronary flow reserve (CFR) (normal cut-off value ≥2). Cardiovascular magnetic resonance (CMR) was performed to assess the ischemic burden by perfusion imaging during regadenoson-induced hyperemia, and the extent of myocardial fibrosis was assessed by late gadolinium enhancement (LGE), native T1 mapping and extracellular volume (ECV). Results: Fourteen patients were enrolled with a mean age of 62.8±6.2years, 8 (57.1%) males, of whom 9 (64.3%) had obstructive HCM. Using IMR, CMD was detected in 4 (29%) patients. Among four patients with an IMR>22.0, all had non-obstructive HCM and two had angina. CFR<2 was reported in eight patients (57%). Concordance between IMR and CFR (both normal or both abnormal) was verified in 6 patients (43%). Among four patients with IMR>22.0, perfusion defects were found in two of the three patients who underwent stress CMR. Increased ECV (>28%) was documented in two of the patients with IMR>22 and in three of the patients with IMR≤22.0. LGE was >15% in 2 of the patients with IMR>22 and in 4 with IMR≤22.0. Conclusions: IMR assessment in HCM is feasible and safe. Patients with abnormal IMR seemed to have more significant tissue abnormalities on CMR. |
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Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic CardiomyopathyÍndice de Resistência Microcirculatória na Avaliação da Disfunção Microvascular Coronária na Miocardiopatia HipertróficaHSM CARCardiovascular Magnetic ResonanceCoronary Flow ReserveHypertrophic CardiomyopathyIndex of Microcirculatory ResistanceIschemiaMicrovascular DysfunctionIntroduction and objectives: Coronary microvascular dysfunction (CMD) is one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). The index of microcirculatory resistance (IMR) is an invasive method to assess the coronary microcirculation. The aim was to assess CMD in patients with HCM by IMR. Methods: Adult patients with HCM without epicardial coronary artery disease underwent cardiac catheterization for the assessment of CMD by IMR (normal cut-off value ≤22.0) and coronary flow reserve (CFR) (normal cut-off value ≥2). Cardiovascular magnetic resonance (CMR) was performed to assess the ischemic burden by perfusion imaging during regadenoson-induced hyperemia, and the extent of myocardial fibrosis was assessed by late gadolinium enhancement (LGE), native T1 mapping and extracellular volume (ECV). Results: Fourteen patients were enrolled with a mean age of 62.8±6.2years, 8 (57.1%) males, of whom 9 (64.3%) had obstructive HCM. Using IMR, CMD was detected in 4 (29%) patients. Among four patients with an IMR>22.0, all had non-obstructive HCM and two had angina. CFR<2 was reported in eight patients (57%). Concordance between IMR and CFR (both normal or both abnormal) was verified in 6 patients (43%). Among four patients with IMR>22.0, perfusion defects were found in two of the three patients who underwent stress CMR. Increased ECV (>28%) was documented in two of the patients with IMR>22 and in three of the patients with IMR≤22.0. LGE was >15% in 2 of the patients with IMR>22 and in 4 with IMR≤22.0. Conclusions: IMR assessment in HCM is feasible and safe. Patients with abnormal IMR seemed to have more significant tissue abnormalities on CMR.Elsevier EspañaRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAguiar Rosa, SMota Carmo, MRocha Lopes, LOliveira, EThomas, BBaquero, LCruz Ferreira, RFiarresga, A2023-02-01T16:18:51Z2022-092022-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4383engRev Port Cardiol. 2022;41(9):761-767. doi: 10.1016/j.repc.2021.07.013.10.1016/j.repc.2021.07.013.info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:46:19Zoai:repositorio.chlc.min-saude.pt:10400.17/4383Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:21:42.782206Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy Índice de Resistência Microcirculatória na Avaliação da Disfunção Microvascular Coronária na Miocardiopatia Hipertrófica |
title |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
spellingShingle |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy Aguiar Rosa, S HSM CAR Cardiovascular Magnetic Resonance Coronary Flow Reserve Hypertrophic Cardiomyopathy Index of Microcirculatory Resistance Ischemia Microvascular Dysfunction |
title_short |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
title_full |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
title_fullStr |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
title_full_unstemmed |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
title_sort |
Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy |
author |
Aguiar Rosa, S |
author_facet |
Aguiar Rosa, S Mota Carmo, M Rocha Lopes, L Oliveira, E Thomas, B Baquero, L Cruz Ferreira, R Fiarresga, A |
author_role |
author |
author2 |
Mota Carmo, M Rocha Lopes, L Oliveira, E Thomas, B Baquero, L Cruz Ferreira, R Fiarresga, A |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Aguiar Rosa, S Mota Carmo, M Rocha Lopes, L Oliveira, E Thomas, B Baquero, L Cruz Ferreira, R Fiarresga, A |
dc.subject.por.fl_str_mv |
HSM CAR Cardiovascular Magnetic Resonance Coronary Flow Reserve Hypertrophic Cardiomyopathy Index of Microcirculatory Resistance Ischemia Microvascular Dysfunction |
topic |
HSM CAR Cardiovascular Magnetic Resonance Coronary Flow Reserve Hypertrophic Cardiomyopathy Index of Microcirculatory Resistance Ischemia Microvascular Dysfunction |
description |
Introduction and objectives: Coronary microvascular dysfunction (CMD) is one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). The index of microcirculatory resistance (IMR) is an invasive method to assess the coronary microcirculation. The aim was to assess CMD in patients with HCM by IMR. Methods: Adult patients with HCM without epicardial coronary artery disease underwent cardiac catheterization for the assessment of CMD by IMR (normal cut-off value ≤22.0) and coronary flow reserve (CFR) (normal cut-off value ≥2). Cardiovascular magnetic resonance (CMR) was performed to assess the ischemic burden by perfusion imaging during regadenoson-induced hyperemia, and the extent of myocardial fibrosis was assessed by late gadolinium enhancement (LGE), native T1 mapping and extracellular volume (ECV). Results: Fourteen patients were enrolled with a mean age of 62.8±6.2years, 8 (57.1%) males, of whom 9 (64.3%) had obstructive HCM. Using IMR, CMD was detected in 4 (29%) patients. Among four patients with an IMR>22.0, all had non-obstructive HCM and two had angina. CFR<2 was reported in eight patients (57%). Concordance between IMR and CFR (both normal or both abnormal) was verified in 6 patients (43%). Among four patients with IMR>22.0, perfusion defects were found in two of the three patients who underwent stress CMR. Increased ECV (>28%) was documented in two of the patients with IMR>22 and in three of the patients with IMR≤22.0. LGE was >15% in 2 of the patients with IMR>22 and in 4 with IMR≤22.0. Conclusions: IMR assessment in HCM is feasible and safe. Patients with abnormal IMR seemed to have more significant tissue abnormalities on CMR. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-09 2022-09-01T00:00:00Z 2023-02-01T16:18:51Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4383 |
url |
http://hdl.handle.net/10400.17/4383 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Port Cardiol. 2022;41(9):761-767. doi: 10.1016/j.repc.2021.07.013. 10.1016/j.repc.2021.07.013. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier España |
publisher.none.fl_str_mv |
Elsevier España |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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