Angiography-Derived and Sensor-Wire Methods to Assess Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction. [Review]
Angiography-Derived and Sensor-Wire Methods to Assess Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction. [Review]
- 2023
ST-segment elevation myocardial infarction (STEMI) treatment with primary percutaneous coronary intervention has dramatically impacted prognosis. However, despite satisfactory angiographic result, occurrence or persistence of coronary microvascular dysfunction after revascularization still affects long-term outcomes. The diagnostic and therapeutic value of understanding the status of coronary microcirculation is gaining attention in the cardiology community. However, current methods to assess microvascular function (namely, cardiac magnetic resonance and invasive wire-based coronary physiology) remain, at least in part, limited by technical and logistic aspects. On the other hand, angiography-based indices of microcirculatory resistance are emerging as valid and user-friendly tools with potential impact on prognostic stratification of patients with STEMI. This review provides an overview about conventional and novel methods to assess coronary microvascular dysfunction in patients with STEMI. The authors also provide a proposed procedural algorithm to facilitate optimal use of wire-based and angiography-based indices in the acute setting of STEMI. Copyright 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
English
1876-7591
10.1016/j.jcmg.2023.01.017 [doi] S1936-878X(23)00089-X [pii]
*Myocardial Infarction
*Percutaneous Coronary Intervention
*ST Elevation Myocardial Infarction
Coronary Angiography
Coronary Circulation
Coronary Vessels/dg [Diagnostic Imaging]
Humans
Microcirculation
Myocardial Infarction/dg [Diagnostic Imaging]
Myocardial Infarction/th [Therapy]
Predictive Value of Tests
ST Elevation Myocardial Infarction/dg [Diagnostic Imaging]
ST Elevation Myocardial Infarction/th [Therapy]
Treatment Outcome--Automated
MedStar Heart & Vascular Institute
Journal Article
Review
ST-segment elevation myocardial infarction (STEMI) treatment with primary percutaneous coronary intervention has dramatically impacted prognosis. However, despite satisfactory angiographic result, occurrence or persistence of coronary microvascular dysfunction after revascularization still affects long-term outcomes. The diagnostic and therapeutic value of understanding the status of coronary microcirculation is gaining attention in the cardiology community. However, current methods to assess microvascular function (namely, cardiac magnetic resonance and invasive wire-based coronary physiology) remain, at least in part, limited by technical and logistic aspects. On the other hand, angiography-based indices of microcirculatory resistance are emerging as valid and user-friendly tools with potential impact on prognostic stratification of patients with STEMI. This review provides an overview about conventional and novel methods to assess coronary microvascular dysfunction in patients with STEMI. The authors also provide a proposed procedural algorithm to facilitate optimal use of wire-based and angiography-based indices in the acute setting of STEMI. Copyright 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
English
1876-7591
10.1016/j.jcmg.2023.01.017 [doi] S1936-878X(23)00089-X [pii]
*Myocardial Infarction
*Percutaneous Coronary Intervention
*ST Elevation Myocardial Infarction
Coronary Angiography
Coronary Circulation
Coronary Vessels/dg [Diagnostic Imaging]
Humans
Microcirculation
Myocardial Infarction/dg [Diagnostic Imaging]
Myocardial Infarction/th [Therapy]
Predictive Value of Tests
ST Elevation Myocardial Infarction/dg [Diagnostic Imaging]
ST Elevation Myocardial Infarction/th [Therapy]
Treatment Outcome--Automated
MedStar Heart & Vascular Institute
Journal Article
Review