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Index of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy

dc.contributor.authorAguiar Rosa, S
dc.contributor.authorMota Carmo, M
dc.contributor.authorRocha Lopes, L
dc.contributor.authorOliveira, E
dc.contributor.authorThomas, B
dc.contributor.authorBaquero, L
dc.contributor.authorCruz Ferreira, R
dc.contributor.authorFiarresga, A
dc.date.accessioned2023-02-01T16:18:51Z
dc.date.available2023-02-01T16:18:51Z
dc.date.issued2022-09
dc.description.abstractIntroduction and objectives: Coronary microvascular dysfunction (CMD) is one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). The index of microcirculatory resistance (IMR) is an invasive method to assess the coronary microcirculation. The aim was to assess CMD in patients with HCM by IMR. Methods: Adult patients with HCM without epicardial coronary artery disease underwent cardiac catheterization for the assessment of CMD by IMR (normal cut-off value ≤22.0) and coronary flow reserve (CFR) (normal cut-off value ≥2). Cardiovascular magnetic resonance (CMR) was performed to assess the ischemic burden by perfusion imaging during regadenoson-induced hyperemia, and the extent of myocardial fibrosis was assessed by late gadolinium enhancement (LGE), native T1 mapping and extracellular volume (ECV). Results: Fourteen patients were enrolled with a mean age of 62.8±6.2years, 8 (57.1%) males, of whom 9 (64.3%) had obstructive HCM. Using IMR, CMD was detected in 4 (29%) patients. Among four patients with an IMR>22.0, all had non-obstructive HCM and two had angina. CFR<2 was reported in eight patients (57%). Concordance between IMR and CFR (both normal or both abnormal) was verified in 6 patients (43%). Among four patients with IMR>22.0, perfusion defects were found in two of the three patients who underwent stress CMR. Increased ECV (>28%) was documented in two of the patients with IMR>22 and in three of the patients with IMR≤22.0. LGE was >15% in 2 of the patients with IMR>22 and in 4 with IMR≤22.0. Conclusions: IMR assessment in HCM is feasible and safe. Patients with abnormal IMR seemed to have more significant tissue abnormalities on CMR.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2022;41(9):761-767. doi: 10.1016/j.repc.2021.07.013.pt_PT
dc.identifier.doi10.1016/j.repc.2021.07.013.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4383
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectCardiovascular Magnetic Resonancept_PT
dc.subjectCoronary Flow Reservept_PT
dc.subjectHypertrophic Cardiomyopathypt_PT
dc.subjectIndex of Microcirculatory Resistancept_PT
dc.subjectIschemiapt_PT
dc.subjectMicrovascular Dysfunctionpt_PT
dc.titleIndex of Microcirculatory Resistance in the Assessment of Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathypt_PT
dc.title.alternativeÍndice de Resistência Microcirculatória na Avaliação da Disfunção Microvascular Coronária na Miocardiopatia Hipertróficapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage767pt_PT
oaire.citation.startPage761pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume41pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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