Impact of sex on the assessment of the microvascular resistance reserve.

CFR CMD Chronic coronary syndromes MRR Sex differences

Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
03 Feb 2024
Historique:
received: 15 09 2023
revised: 29 12 2023
accepted: 01 02 2024
medline: 6 2 2024
pubmed: 6 2 2024
entrez: 5 2 2024
Statut: aheadofprint

Résumé

The microvascular resistance reserve (MRR) is an innovative index to assess the vasodilatory capacity of the coronary circulation while accounting for the presence of concomitant epicardial disease. The MRR has shown to be a valuable diagnostic and prognostic tool in the general coronary artery disease (CAD) population. However, considering the fundamental aspects of its assessment and the unique hemodynamic characteristics of women, it is crucial to provide additional considerations for evaluating the MRR specifically in women. The aim of this study was to assess the diagnostic and prognostic applicability of the MRR in women and assess the potential differences across different sexes. From the ILIAS Registry, we enrolled all patients with a stable indication for invasive coronary angiography, ensuring complete physiological and follow-up data. We analyzed the diagnostic value by comparing differences between sexes and evaluated the prognostic value of the MRR specifically in women, comparing it to that in men. A total of 1494 patients were included of which 26% were women. The correlation between MRR and CFR was good and similar between women (r = 0.80, p < 0.005) and men (r = 0.81, p < 0.005). The MRR was an independent and important predictor of MACE in both women (HR 0.67, 0.47-0.96, p = 0.027) and men (HR 0.84, 0.74-0.95, p = 0.007). The optimal cut-off value for MRR in women was 2.8 and 3.2 in men. An abnormal MRR similarly predicted MACE at 5-year follow-up in both women and men. The MRR seems to be equally applicable in both women and men with stable coronary artery disease.

Sections du résumé

BACKGROUND BACKGROUND
The microvascular resistance reserve (MRR) is an innovative index to assess the vasodilatory capacity of the coronary circulation while accounting for the presence of concomitant epicardial disease. The MRR has shown to be a valuable diagnostic and prognostic tool in the general coronary artery disease (CAD) population. However, considering the fundamental aspects of its assessment and the unique hemodynamic characteristics of women, it is crucial to provide additional considerations for evaluating the MRR specifically in women.
AIM OBJECTIVE
The aim of this study was to assess the diagnostic and prognostic applicability of the MRR in women and assess the potential differences across different sexes.
METHODS METHODS
From the ILIAS Registry, we enrolled all patients with a stable indication for invasive coronary angiography, ensuring complete physiological and follow-up data. We analyzed the diagnostic value by comparing differences between sexes and evaluated the prognostic value of the MRR specifically in women, comparing it to that in men.
RESULTS RESULTS
A total of 1494 patients were included of which 26% were women. The correlation between MRR and CFR was good and similar between women (r = 0.80, p < 0.005) and men (r = 0.81, p < 0.005). The MRR was an independent and important predictor of MACE in both women (HR 0.67, 0.47-0.96, p = 0.027) and men (HR 0.84, 0.74-0.95, p = 0.007). The optimal cut-off value for MRR in women was 2.8 and 3.2 in men. An abnormal MRR similarly predicted MACE at 5-year follow-up in both women and men.
CONCLUSION CONCLUSIONS
The MRR seems to be equally applicable in both women and men with stable coronary artery disease.

Identifiants

pubmed: 38316189
pii: S0167-5273(24)00197-9
doi: 10.1016/j.ijcard.2024.131832
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131832

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Auteurs

Coen K M Boerhout (CKM)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

C E M Vink (CEM)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Joo Myung Lee (JM)

Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Seoul, Republic of Korea.

Guus A de Waard (GA)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Hernan Mejia-Renteria (H)

Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain.

Seung Hun Lee (SH)

Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.

Ji-Hyun Jung (JH)

Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea.

Masahiro Hoshino (M)

Gifu Heart Center, Department of Cardiovascular Medicine, Gifu, Japan.

Mauro Echavarria-Pinto (M)

Hospital General ISSSTE Querétaro - Facultad de Medicina, Universidad Autónoma de Querétaro, Querétaro, Mexico.

Martijn Meuwissen (M)

Department of Cardiology, Amphia Hospital, Breda, the Netherlands.

Hitoshi Matsuo (H)

Gifu Heart Center, Department of Cardiovascular Medicine, Gifu, Japan.

Maribel Madera-Cambero (M)

Tergooi Hospital, Department of Cardiology, Blaricum, the Netherlands.

Ashkan Eftekhari (A)

Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark.

Mohamed A Effat (MA)

Division of Cardiovascular Health and Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA.

Tadashi Murai (T)

Tsuchiura Kyodo General Hospital, Department of Cardiology, Tsuchiura City, Japan.

Koen Marques (K)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Joon-Hyung Doh (JH)

Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea.

Evald H Christiansen (EH)

Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark.

Rupak Banerjee (R)

Mechanical and Materials Engineering Department, University of Cincinnati Cincinnati, OH, USA; Research Services, Veteran Affairs Medical Center, Cincinnati, OH, USA.

Chang-Wook Nam (CW)

Department of Medicine, Keimyung University, Daegu, South Korea.

Giampaolo Niccoli (G)

Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Institute of Cardiology, Rome, Italy.

Masafumi Nakayama (M)

Gifu Heart Center, Department of Cardiovascular Medicine, Gifu, Japan; Toda Central General Hospital, Cardiovascular Center, Toda, Japan.

Nobuhiro Tanaka (N)

Tokyo Medical University Hachioji Medical Center, Department of Cardiology, Tokyo, Japan.

Eun-Seok Shin (ES)

Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

Yolande Appelman (Y)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Marcel A M Beijk (MAM)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Niels van Royen (N)

Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands.

Steven A J Chamuleau (SAJ)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Paul Knaapen (P)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Javier Escaned (J)

Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain.

Tsunekazu Kakuta (T)

Tsuchiura Kyodo General Hospital, Department of Cardiology, Tsuchiura City, Japan.

Bon Kwon Koo (BK)

Seoul National University Hospital, Department of Internal Medicine, Cardiovascular Center, Seoul, Republic of Korea.

Jan J Piek (JJ)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands.

Tim P van de Hoef (TP)

Heart Center, Amsterdam UMC, Amsterdam, the Netherlands; Department of Cardiology, University Medical Centre Utrecht, the Netherlands. Electronic address: t.p.vandehoef@umcutrecht.nl.

Classifications MeSH