Assessment of coronary microvascular dysfunction by angiography-based index of microcirculatory resistance: an indirect meta-analysis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Pub Date : 2024-11-11 DOI:10.1159/000541630

Wei Wen, Yi Chi, Mingwang Liu, Beili Xie, Mengjie Gao, Lulian Jiang, Yiqing Zhang, Keji Chen, Fuhai Zhao

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Abstract

Introduction: There is a lack of consensus on diagnosing coronary microvascular dysfunction (CMD) using the angiography-based index of microcirculatory resistance (Angio-IMR) due to the absence of evidence. This study aims to explore the efficacy of Angio-IMR in diagnosing CMD.

Methods: A systematic search was conducted in PubMed, Embase, Scopus, and Cochrane Library for studies primarily focusing on Angio-IMR diagnosing CMD, using IMR as the gold standard. The primary results were pooled sensitivity, specificity, and the area under curve (AUC).

Results: A total of 15 studies involving 2202 individuals and 2330 vessels were included in our study, Angio-IMR demonstrated high performance in predicting IMR with overall pooled sensitivity and specificity of 0.84 (95% confidence interval (CI): 0.81 to 0.87) and 0.87 (95%CI: 0.83 to 0.99), respectively, and AUC=0.91 (95%CI: 0.89 to 0.94). This indicates that Angio-IMR has good diagnostic characteristics. Subgroup analysis by indirect meta-analysis showed higher sensitivity in the rest state. However, there is no significant difference in sensitivity and specificity between the hyperemic and rest states when using the AccuIMR system. Furthermore, sensitivity and specificity were more pronounced in the group without coronary pressure monitoring compared to the group with monitoring.

Conclusion: Angio-IMR is an alternative tool to identify CMD.

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通过基于血管造影的微循环阻力指数评估冠状动脉微血管功能障碍：间接荟萃分析。

导言：由于缺乏证据，使用基于血管造影的微循环阻力指数（Angio-IMR）诊断冠状动脉微血管功能障碍（CMD）缺乏共识。本研究旨在探讨 Angio-IMR 在诊断 CMD 方面的有效性：方法：在 PubMed、Embase、Scopus 和 Cochrane 图书馆中进行了系统性检索，以 IMR 作为金标准，主要关注 Angio-IMR 诊断 CMD 的研究。主要结果是汇总灵敏度、特异性和曲线下面积（AUC）：我们的研究共纳入了 15 项研究，涉及 2202 人和 2330 根血管。Angio-IMR 在预测 IMR 方面表现出色，总体汇总灵敏度和特异度分别为 0.84（95% 置信区间 (CI)：0.81 至 0.87）和 0.87（95%CI：0.83 至 0.99），AUC=0.91（95%CI：0.89 至 0.94）。这表明 Angio-IMR 具有良好的诊断特性。通过间接荟萃分析进行的亚组分析表明，静息状态下的灵敏度更高。但是，使用 AccuIMR 系统时，充血状态和静息状态的敏感性和特异性没有明显差异。此外，无冠状动脉压力监测组的敏感性和特异性比有监测组更明显：结论：血管造影成像系统是识别冠状动脉疾病的另一种工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.