ArticleCirculation2003
Novel index for invasively assessing the coronary microcirculation.
Article in Circulation, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 12 registered trials, which are not on this map. Cited by 265 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Impact of PCSK9 Inhibitors on Coronary Microvascular Dysfunction in Patients With Atherosclerotic Cardiovascular Disease Proved by Myocardial Ischemia and Needing Coronarography : a Monocentric, Prospective, Randomized and Open-label Phase II Trial
Effect of the Antidiabetic Drug DAPAgliflozin on the Coronary Macrovascular and MICROvascular Function in Type 2 Diabetic Patients
The Study to Assess the Effect of Trimetazidine on Index of Microcirculatory Resistance (IMR), Measured by Coronary Pressure and Temperature Wire, in Patients With Stable Coronary Artery Disease
Impact of Polyethylene Terephthalate Micronet Mesh-Covered Stent (MGuard) on Coronary Microcirculation's Lesions in Patients With ST or Non ST-segment Elevation Myocardial Infarction (STE and NSTE-ACS): Assessment by Index of Microcirculatory Resistance (IMR)
EARLY Microvascular Dysfunction Prediction Using Quantitative Flow Ratio After ST-segment Elevation MYOcardial Infarction (EARLY-MYO-QFR I)
EARLY Microvascular Dysfunction Assessment Using Quantitative Flow Ratio After ST-segment Elevation MYOcardial Infarction (EARLY-MYO-QFR II)
EARLY Microvascular Dysfunction Prediction Using Quantitative Flow Ratio in ST-segment Elevation MYOcardial Infarction Patients With Pharmaco-Invasive Strategy (EARLY-MYO-QFR PI)
A Prospective, Multi-center Clinical Trial for Evaluating the Effectiveness and Safety of Coronary Angiography-Derived Index of Microcirculatory Resistance Measured Online by a Coronary Functional Measurement System
Coronary Microcirculation and Troponin Elevation in Septic Shock
Coronary Microvascular Dysfunction in Chronic Coronary Syndrome - Invasive Assessment With Thermo-dilution Technique in the LAD and Biobanking in an All-comer Population
Selution Sirolimus Coated Balloon (MedAlliance) Versus SeQuent Please Neo Paclitaxel Coated Balloon (Bbraun) for the Treatment of de Novo Coronary Artery Lesions in Medium-small Size Vessels.
Inhibition of Late Sodium Current (INa) to Prevent Coronary MICROvascular Dysfunction in Patients Presenting With ST-Elevation Myocardial Infarction and Multivessel Disease: A Multicenter, Randomized, Controlled and Open Label Study (INaMICRON Study)
Who cites it
265 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Angiography-based coronary microvascular assessment with and without intracoronary pressure measurements: a systematic review.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Pooled it
- Pooled it
- Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study.Circulation · 2026Trial
- Trial
- Reproducibility of bolus versus continuous thermodilution for assessment of coronary microvascular function in patients with ANOCA.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Trial
- Evolocumab for prevention of microvascular dysfunction in patients undergoing percutaneous coronary intervention: the randomised, open-label EVOCATION trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022Trial
- Effects of Danhong Injection () on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study.Chinese journal of integrative medicine · 2021Trial
- Effect of Danhong Injection () on Improving Coronary Microcirculation Injury after Percutaneous Coronary Intervention.Chinese journal of integrative medicine · 2021Trial
- Genetic dysregulation of endothelin-1 is implicated in coronary microvascular dysfunction.European heart journal · 2020Trial
- Effects of Intracoronary Alteplase on Microvascular Function in Acute Myocardial Infarction.Journal of the American Heart Association · 2020Trial
- Effects of different strategies on high thrombus burden in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary catheterization.Coronary artery disease · 2019Trial
- Systemic microvascular dysfunction in microvascular and vasospastic angina.European heart journal · 2018Trial
- Remote Ischemic Preconditioning Acutely Improves Coronary Microcirculatory Function.Journal of the American Heart Association · 2018Trial
- Coronary microvascular dysfunction in patients with stable coronary artery disease: The CE-MARC 2 coronary physiology sub-study.International journal of cardiology · 2018Trial
- Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application.Cardiovascular intervention and therapeutics · 2026Review
- Reply: Shifting Baseline of Continuous Thermodilution.JACC. Case reports · 2026Article
- Validity of angiography-derived microvascular resistance in hypertrophic cardiomyopathy: a head-to-head comparison with pressure-wire IMR.The international journal of cardiovascular imaging · 2026Article
- Coronary Microvascular Dysfunction in Hemodialysis-Dependent End-Stage Renal Disease: Prevalence, Characteristics, and Prognostic Implications.Circulation reports · 2026Article
- Contrast Arrival Time at the Ankle as a Quantitative Perfusion Index for Ulcer Healing Prediction After Below-the-Knee Angioplasty in Chronic Limb-Threatening Ischemia.Cardiovascular and interventional radiology · 2026Article
- Reperfusion Injury and Infarct Size: Why Translation has Been Difficult, and How We Move Forward.Current cardiology reports · 2026Review
205 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA relatively simple, invasive method for quantitatively assessing the status of the coronary microcirculation independent of the epicardial artery is lacking. METHODS AND
resultsBy using a coronary pressure wire and modified software, it is possible to calculate the mean transit time of room-temperature saline injected down a coronary artery. The inverse of the hyperemic mean transit time has been shown to correlate with absolute flow. We hypothesize that distal coronary pressure divided by the inverse of the hyperemic mean transit time provides an index of microcirculatory resistance (IMR) that will correlate with true microcirculatory resistance (TMR), defined as the distal left anterior descending (LAD) pressure divided by hyperemic flow, measured with an external ultrasonic flow probe. A total of 61 measurements were made in 9 Yorkshire swine at baseline and after disruption of the coronary microcirculation, both with and without an epicardial LAD stenosis. The mean IMR (16.9+/-6.5 U to 25.9+/-14.4 U, P=0.002) and TMR (0.51+/-0.14 to 0.79+/-0.32 mm Hg x mL(-1) x min(-1), P=0.0001), as well as the % change in IMR (147+/-66%) and TMR (159+/-105%, P=NS versus IMR % change), increased significantly and to a similar degree after disruption of the microcirculation. These changes were independent of the status of the epicardial artery. There was a significant correlation between mean IMR and TMR values, as well as between the % change in IMR and % change in TMR.
conclusionsMeasuring IMR may provide a simple, quantitative, invasive assessment of the coronary microcirculation.
Indexed as
Identifiers
12821539What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.