Pubblicazioni

Autori:

Castaldi, Gianluca; Fezzi, Simone; Widmann, Maddalena; Lia, Micaela; Rizzetto, Francesca; Mammone, Concetta; Pazzi, Sara; Piccolo, Solange; Galli, Verdiana; Pighi, Michele; Pesarini, Gabriele; Prati, Daniele; Ferrero, Valeria; Scarsini, Roberto; Tavella, Domenico; Ribichini, Flavio

Titolo:

Angiography-derived index of microvascular resistance in takotsubo syndrome

Anno:

2023

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING

ISSN Rivista:

1875-8312

N° Volume:

39

Numero o Fascicolo:

1

Intervallo pagine:

233-244

Parole chiave:

Coronary physiology; Index of microvascular resistance; Quantitative flow ratio; Takotsubo syndrome

Breve descrizione dei contenuti:

: Coronary microvascular dysfunction (CMD) has been proposed as a key driver in the etiopathogenesis of Takotsubo syndrome (TTS), likely related to an "adrenergic storm" upon a susceptible microvascular circulation. The aim of our manuscript was to assess CMD in patients with TTS through the computation of the angiography-derived index of microcirculatory resistance (IMR) and its correlation with clinical presentation. Coronary angiograms of 41 consecutive TTS patients were retrospectively analyzed to derive angiography-based indices of CMD. Three indices (NH-IMRangio, AngioIMR and A-IMR) were calculated based on quantitative flow ratio. CMD was defined as an IMRangio value ≥ 25 units. The correlation between CMD and clinical presentation was then assessed. Median age was 76 years, 85.7% were women and mean left ventricular ejection fraction (LVEF) at first echocardiogram was 41.2%. Angiography-derived IMR was higher in left anterior descending artery (LAD) than circumflex and right coronary artery with either NH-IMRangio (53.9 ± 19.8 vs 35.8 ± 15.4 vs 40.8 ± 18.5, p-value < 0.001), AngioIMR (47.2 ± 17.3 vs 31.8 ± 12.2 vs 37.3 ± 13.7, p-value < 0.001) or A-IMR (52.7 ± 19 vs 36.1 ± 14.1 vs 41.8 ± 16.1, p-value < 0.001). All patients presented CMD with angiography-derived IMR ≥ 25 in at least one territory with each formula. Angiography-derived IMR in LAD territory was significantly higher in patients presenting with LVEF impairment (≤ 40%) than in those with preserved ventricular global function (NH-IMRangio: 59.3 ± 18.1 vs 46.3 ± 16.0 p-value = 0.030; AngioIMR: 52.9 ± 17.8 vs 41.4 ± 14.2, p-value = 0.037; A-IMR: 59.2 ± 18.6 vs 46.3 ± 17.0, p-value = 0.035). CMD assessed with angiography-derived IMR is a common finding in TTS and it is inversely correlated with LV function. The available formulas have a substantial superimposable diagnostic performance in assessing coronary microvascular function.

Id prodotto:

131432

Handle IRIS:

11562/1082910

ultima modifica:

28 settembre 2023

Citazione bibliografica:

Castaldi, Gianluca; Fezzi, Simone; Widmann, Maddalena; Lia, Micaela; Rizzetto, Francesca; Mammone, Concetta; Pazzi, Sara; Piccolo, Solange; Galli, Verdiana; Pighi, Michele; Pesarini, Gabriele; Prati, Daniele; Ferrero, Valeria; Scarsini, Roberto; Tavella, Domenico; Ribichini, Flavio, Angiography-derived index of microvascular resistance in takotsubo syndrome «THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING» , vol. 39 , n. 1 , 2023 , pp. 233-244

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