ArticleThe international journal of cardiovascular imaging2023
Angiography-derived index of microvascular resistance in takotsubo syndrome.
Article in The international journal of cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Coronary Microvascular Dysfunction in Stress Cardiomyopathy: At the Heart of the Problem.Life (Basel, Switzerland) · 2026Review
- Angiography-derived assessment of coronary microcirculatory resistance in patients with chronic total occlusion.Heart and vessels · 2026Article
- Angiographic and functional assessment after paclitaxel or sirolimus drug-coated balloons for de novo coronary artery disease in small vessels: PICCOLETO VI study.AsiaIntervention · 2026Article
- Association between the Tpeak-Tend interval on admission and coronary microvascular dysfunction in Takotsubo syndrome.ESC heart failure · 2025Article
- Coronary microvascular dysfunction is a hallmark of all subtypes of MINOCA.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- Impact of Coronary Microvascular Dysfunction in Takotsubo Syndrome: Cause, Consequence or Both?Reviews in cardiovascular medicine · 2024Review
- Takotsubo Syndrome and Coronary Artery Disease: Which Came First-The Chicken or the Egg?Journal of cardiovascular development and disease · 2024Review
- A proposal of a new index of coronary microvascular resistance based on the duration of the transient ECG repolarization changes during coronary angiography.The international journal of cardiovascular imaging · 2023Article
- In Vivo Validation of a Novel Computational Approach to Assess Microcirculatory Resistance Based on a Single Angiographic View.Journal of personalized medicine · 2022Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
16 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
Indexed as
Identifiers
What 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.