Invasive microvascular coronary circulation assessment in patients with coronary artery aneurysmal disease

Iwańczyk, Sylwia; Smukowska-Gorynia, Anna; Woźniak, Patrycja; Grygier, Marek; Lesiak, Maciej; Araszkiewicz, Aleksander

doi:10.20452/pamw.16392

Cited by 1 publication

(1 citation statement)

References 13 publications

(14 reference statements)

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“…Studies using positron emission tomography (PET) and cardiac magnetic resonance (CMR) for non-invasive quantification of regional MBF have shown that CMD can be detected in many clinical conditions without visible stenoses of large epicardial arteries. However, the experience using non-invasive CMD methods as predictive tools in HTX patients still needs improvement [16]. Bravo et al reported, in a cohort of 94 transplant patients, that quantifying absolute MBF using PET improves CAV detection compared to conventional semi-quantitative myocardial perfusion imaging (MPI), providing better patient stratification [17].…”

Section: Coronary Microcirculation Assessment Methodsmentioning

confidence: 99%

Microcirculatory Disease in Patients after Heart Transplantation

Iwańczyk

Woźniak

Smukowska-Gorynia

et al. 2023

JCM

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Although the treatment and prognosis of patients after heart transplantation have significantly improved, late graft dysfunction remains a critical problem. Two main subtypes of late graft dysfunction are currently described: acute allograft rejection and cardiac allograft vasculopathy, and microvascular dysfunction appears to be the first stage of both. Studies revealed that coronary microcirculation dysfunction, assessed by invasive methods in the early post-transplant period, correlates with a higher risk of late graft dysfunction and death during long-term follow-up. The index of microcirculatory resistance, measured early after heart transplantation, might identify the patients at higher risk of acute cellular rejection and major adverse cardiovascular events. It may also allow optimization and enhancement of post-transplantation management. Moreover, cardiac allograft vasculopathy is an independent prognostic factor for transplant rejection and survival rate. The studies showed that the index of microcirculatory resistance correlates with anatomic changes and reflects the deteriorating physiology of the epicardial arteries. In conclusion, invasive assessment of the coronary microcirculation, including the measurement of the microcirculatory resistance index, is a promising approach to predict graft dysfunction, especially the acute allograft rejection subtype, during the first year after heart transplantation. However, further advanced studies are needed to fully grasp the importance of microcirculatory dysfunction in patients after heart transplantation.

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Section: Coronary Microcirculation Assessment Methodsmentioning

confidence: 99%