Yongzhen Fan
1
Shuang Wang
2
Zhi-Bing Lu
1
Hongzhi Lan
4*
Xiaorong Hu
1*The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Med.
Sec. Precision Medicine
Volume 12 - 2025 |
doi: 10.3389/fmed.2025.1490346
This article is part of the Research Topic Precision Medicine: Biomarker Testing for Diagnosis and Treatment of Cardiovascular Disease View all 5 articles
Diagnostic Performance of Multi-Branch Coronary Angiography-Based Index of Microcirculatory Resistance: A Novel Approach
Provisionally accepted- 1 Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, China;, Department of Cardiology, Zhongnan Hospital, Wuhan University, Wuhan, Hebei Province, China
- 2 Department of Cardiovascular Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, China, Wuhan, China
- 3 Department of Cardiology, The First Affiliated Hospital of Nanchang Medical College., Nanchang, China
- 4 Shenzhen Raysightmed Co, Ltd, Shenzhen, China
Background: Wire-based index of microcirculatory resistance (IMR) utilizing pressure wires and thermodilution techniques for the assessment of coronary microcirculatory function, presents challenges for clinical routine use due to its complexity, time-consuming, and costly. This study introduces a novel multi-branch and wire-free method for IMR calculation based on coronary angiography. The diagnostic performance of CAG-IMR is validated within a retrospective single-center investigation. Methods: In a retrospective single-center study, 139 patients with 201 vessels were evaluated using CAG-IMR for coronary microvascular dysfunction (CMD) detection, utilizing wire-based IMR as the reference standard. CMD was determined based on wire-based IMR ≥25U. CAG-IMR was independently calculated from diagnostic coronary angiography in a blinded fashion, employing the same diagnostic threshold of 25U for CMD identification. Results: CAG-IMR demonstrated significant correlation (r=0.84, p<0.001) and good diagnostic performance AUC=0.97 (95% CI: 0.95 to 0.99) compared to wire-based IMR. It exhibited the overall diagnostic accuracy at 95.0% (95% CI: 92.0% to 98.0%), alongside high sensitivity (92.7%) and specificity (95.6%). The positive predictive value (PPV) stood at 84.4%, and the negative predictive value (NPV) reached 98.1%. Conclusions: This study introduces CAG-IMR, a novel, multi-branch and wire-free method for IMR calculation. The indicator demonstrates good diagnostic accuracy and correlation with wire-based IMR in a cohort of 139 patients and 201 vessels, with the potential to enhance clinical CMD assessment.
Keywords: index of microcirculatory resistance (IMR), Retrospective, coronary angiography-based IMR (CAG-IMR), Computational Fluid Dynamics (CFD), Coronary microvascular dysfunction (CMD)
Received: 03 Sep 2024; Accepted: 02 Jan 2025.
Copyright: © 2025 Fan, Wang, Cai, Lu, Ma, Lan and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongzhi Lan, Shenzhen Raysightmed Co, Ltd, Shenzhen, China
Xiaorong Hu, Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, China;, Department of Cardiology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, Hebei Province, China
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