Prognostic Value of Microvascular Resistance at Rest in Patients With Takotsubo Syndrome
BACKGROUND Microvascular resistance (MR) is increased in takotsubo syndrome (TTS) and can be assessed by a validated pressure-wire-free tool called nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio). OBJECTIVES The authors aimed to study whether the degree and extent...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p1610 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/1610 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85134976180&doi=10.1016%2fj.jcmg.2022.03.030&partnerID=40&md5=4fa7876d657eb8ae56874660c94baae4 |
| Access Level: | acceso abierto |
| Palabra clave: | coronary microvascular dysfunction (CMD), nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio), takotsubo syndrome (TTS) |
| Sumario: | BACKGROUND Microvascular resistance (MR) is increased in takotsubo syndrome (TTS) and can be assessed by a validated pressure-wire-free tool called nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMRangio). OBJECTIVES The authors aimed to study whether the degree and extent of an altered MR in TTS patients were associated with 1-year prognosis. METHODS The authors recruited 181 consecutive patients with TTS who underwent cardiac angiography. Impaired MR was defined as an NH-IMRangio >= 25. The degree and extent of impaired MR were assessed by the value of maximum NH-IMRangio in each major coronary artery and by the number of coronary arteries with an NH-IMRangio >= 25, respectively. Major adverse cardiac events (MACE) were a composite of cardiovascular death, heart failure event, acute myocardial infarction, and hospitalization for symptomatic arrhythmias. RESULTS A total of 166 patients had NH-IMRangio available. The mean age was 74.8 years, and 83% were women. The rate of MACE at 1 year was 21.1%, mainly due to heart failure events that were generally mild. Kaplan-Meier curves showed higher rates of MACE in patients with higher NH-IMRangio (28.9% vs 13.3%; P = 0.019) and in those with 3 coronary arteries with increased MR compared to those with 2 or 1 affected arteries (33.3% vs 15.9% vs 9.5%; P = 0.040 and P = 0.040, respectively). After a multivariable Cox regression analysis, higher values of NH-IMRangio (HR: 3.41 [95% CI: 1.54-7.52]; P = 0.002) and the presence of 3 coronary arteries with increased MR (HR: 6.39 [95% CI: 1.46-27.87]; P = 0.014) were independent predictors of MACE in TTS patients. CONCLUSIONS The degree and extent of an impaired MR assessed by a validated pressure-wire-free toot were independent predictors of MACE at 1-year follow-up in ITS patients. (C) 2022 by the American College of Cardiology Foundation. |
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