Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
Minimal Microvascular Resistance: Agreement Between Continuous and Bolus Thermodilution.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Mahendiran Thabo, Keulards Daniëlle, Pijls Nico H J, Viscusi Michele, Gallinoro Emanuele, Bertolone Dario, Damman Peter, van Royen Niels, Sonck Jeroen, Collet Carlos, Wilgenhof Adriaan, Knaapen Paul, De Bruyne Bernard
Аннотация
BACKGROUND: Continuous thermodilution quantifies absolute microvascular resistance (Rμ, Wood units), a key metric of microvascular function. Rμ is minimal during hyperemia (Rμ,hyper) with increased Rμ,hyper suggestive of microvascular dysfunction. Bolus thermodilution measures the index of microcirculatory resistance (IMR), a dimensionless surrogate of Rμ,hyper.
AIMS: We compared Rμ,hyper measured by continuous thermodilution (invasive Rμ,hyper) with the gold standard [15O]H2O positron emission tomography (PET Rμ,hyper), and assessed the correlation between invasive Rμ,hyper and IMR.
METHODS: First, the accuracy of invasive Rμ,hyper was assessed in a cohort of 24 patients in which both invasive Rμ,hyper and PET Rμ,hyper were measured in the left anterior descending (LAD) and circumflex (LCX) arteries, corresponding to 46 measurements of Rμ,hyper in total (LAD = 24, LCX = 22). Next, agreement between invasive Rμ,hyper and IMR was evaluated in the LAD in a cohort of 250 patients with angina and non-obstructive coronary arteries.
RESULTS: Invasive Rμ,hyper exhibited a strong correlation with PET Rμ,hyper (r = 0.86 [95% CI 0.76-0.92], p < 0.001), with good absolute agreement (ICC 0.82 [95% CI 0.70-0.90], p < 0.001). Passing-Bablok regression analysis found no significant systematic (intercept A: 54.53 [95% CI -18.95 to 120.96]) or proportional (slope B: 0.90 [95% CI 0.71-1.15]) bias between invasive Rμ,hyper and PET Rμ,hyper. However, invasive Rμ,hyper exhibited no significant correlation with IMR (r = 0.11 [95% CI -0.01 to 0.23], p = 0.08).
CONCLUSION: Invasive Rμ,hyper derived from continuous thermodilution exhibited excellent agreement with noninvasive Rμ,hyper measured by [15O]H2O PET, the current non-invasive standard of reference. In contrast, IMR exhibited no significant correlation with invasive Rμ,hyper in patients with angina and non-obstructive coronary arteries.
AIMS: We compared Rμ,hyper measured by continuous thermodilution (invasive Rμ,hyper) with the gold standard [15O]H2O positron emission tomography (PET Rμ,hyper), and assessed the correlation between invasive Rμ,hyper and IMR.
METHODS: First, the accuracy of invasive Rμ,hyper was assessed in a cohort of 24 patients in which both invasive Rμ,hyper and PET Rμ,hyper were measured in the left anterior descending (LAD) and circumflex (LCX) arteries, corresponding to 46 measurements of Rμ,hyper in total (LAD = 24, LCX = 22). Next, agreement between invasive Rμ,hyper and IMR was evaluated in the LAD in a cohort of 250 patients with angina and non-obstructive coronary arteries.
RESULTS: Invasive Rμ,hyper exhibited a strong correlation with PET Rμ,hyper (r = 0.86 [95% CI 0.76-0.92], p < 0.001), with good absolute agreement (ICC 0.82 [95% CI 0.70-0.90], p < 0.001). Passing-Bablok regression analysis found no significant systematic (intercept A: 54.53 [95% CI -18.95 to 120.96]) or proportional (slope B: 0.90 [95% CI 0.71-1.15]) bias between invasive Rμ,hyper and PET Rμ,hyper. However, invasive Rμ,hyper exhibited no significant correlation with IMR (r = 0.11 [95% CI -0.01 to 0.23], p = 0.08).
CONCLUSION: Invasive Rμ,hyper derived from continuous thermodilution exhibited excellent agreement with noninvasive Rμ,hyper measured by [15O]H2O PET, the current non-invasive standard of reference. In contrast, IMR exhibited no significant correlation with invasive Rμ,hyper in patients with angina and non-obstructive coronary arteries.