Angiography-Derived Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Status: A Systematic Review and Meta-Analysis

Peregrina, Estefanía Fernández; García‐García, Héctor M.; Roselló, Jordi Sans; Sánchez, Jorge Sanz; Kotronias, Rafail A.; Scarsini, Roberto; Tebaldi, Matteo; Echavarría-Pinto, Mauro; Maria, Giovanni Luigi De

doi:10.1016/j.carrev.2022.06.168

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“…Patients diagnosed with CMD were classified based on specific criteria: a CFR value of less than 2.0-2.5 and an IMR 12 equal to or exceeding 25. For precise classification, cases within a borderline range were thoroughly evaluated by a multidisciplinary heart team to ascertain the likelihood of CMD diagnosis 2 .…”

Section: Methodsmentioning

confidence: 99%

Investigating Electrocardiographic Abnormalities in Patients with Coronary Microvascular Dysfunction

Merdler,

Hill,

Ozturk

et al. 2024

Preprint

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BACKGROUND: Coronary microvascular dysfunction (CMD) is a frequently overlooked and underdiagnosed mechanism of cardiac ischemia despite its heightened risk of major adverse cardiovascular events. The potential impact of CMD on the conduction system and occurrence of arrhythmias has received limited attention. This study aimed to examine the link between CMD and surface electrocardiography (ECG). METHODS: We harnessed the Coronary Microvascular Disease registry (CMDR), utilizing the CoroVentis CoroFlow System (Abbott) to invasively assess patients presenting with symptomatic chest pain. All patients underwent microvascular assessment of the left anterior descending artery territory. Our cohort was stratified into two groups, CMD-positive and CMD-negative, with an analysis of the most recent ECG performed prior to the invasive evaluation for each patient. RESULTS: Our cohort comprised 230 patients, of which 60 were classified as CMD-positive and 170 as CMD-negative. T-wave inversion was observed in 30.5% of CMD-positive patients compared to 20% in the CMD-negative group (P=0.09), and ST depression was identified in 6.7% of CMD-positive patients compared to 2.4% of CMD-negative patients (P=0.12). There were no differences in conduction disorders, such as left bundle branch block (LBBB), left anterior hemiblock (LAHB), left posterior hemiblock (LPHB), right bundle branch block (RBBB), incomplete right bundle branch block (ICRBBB), and bifascicular block, between the two groups. There were no discernible distinctions in the ECG intervals, including the PR, QRS, and QT. There was a trend of increased left ventricular hypertrophy (LVH) according to the ECG criteria in patients with CMD (11.7% vs. 5.3%; P=0.09). CONCLUSION: Our study revealed a tendency toward ischemic and hypertrophic ECG changes among CMD-positive patients, but no differences in the occurrence of conduction disorders in patients with and without CMD. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier:NCT05960474GRAPHIC ABSTRACT: A graphic abstract is available for this article.

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Section: Methodsmentioning

confidence: 99%