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Microvascular Resistance Reserve forAssessment of Coronary MicrovascularFunction: JACC Technology Corner. Journal of the American College of Cardiology De Bruyne, B., Pijls, N. H., Gallinoro, E., Candreva, A., Fournier, S., Keulards, D. C., Sonck, J., Van't Veer, M., Barbato, E., Bartunek, J., Vanderheyden, M., Wyffels, E., De Vos, A., El Farissi, M., Tonino, P. A., Muller, O., Collet, C., Fearon, W. F. 2021; 78 (15): 1541-1549

Abstract

The need for a quantitative and operator-independent assessment of coronary microvascular function is increasingly recognized. We propose the theoretical framework of microvascular resistance reserve (MRR) as an index specific for the microvasculature, independent of autoregulation and myocardial mass, and based on operator-independent measurements of absolute values of coronary flow and pressure. In its general form, MRR equals coronary flow reserve (CFR) divided by fractional flow reserve (FFR) corrected for driving pressures. In 30 arteries, pressure, temperature, and flow velocity measurements were obtained simultaneously at baseline (BL), during infusion of saline at 10mL/min (rest) and 20mL/min (hyperemia). A strong correlation was found between continuous thermodilution-derived MRR and Doppler MRR (r=0.88; 95% confidence interval: 0.72-0.93; P< 0.001). MRR was independent from the epicardial resistance, the lower the FFR value, the greater the difference between MRR and CFR. Therefore, MRR is proposed as a specific, quantitative, and operator-independent metric to quantify coronary microvascular dysfunction.

View details for DOI 10.1016/j.jacc.2021.08.017

View details for PubMedID 34620412