Background. To validate a simplified invasive method for the calculation of the index of microvascular resistance (IMR). Methods. This is a prospective, single-center study of patients with chronic coronary syndromes presenting with nonobstructive coronary artery disease. IMR was obtained using both intravenous (IV) adenosine and intracoronary (IC) papaverine. Each IMR measurement was obtained in duplicate. The primary objective was the agreement between IMR acquired using adenosine and papaverine. Secondary objectives include reproducibility of IMR and time required for the IMR measurement. Results. One hundred and sixteen IMR measurements were performed in 29 patients. The mean age was 68.8 ± 7.24 years, and 27.6% was diabetics. IMR values were similar between papaverine and adenosine (17.7 ± 7.26 and 20.1 ± 8.6, ; Passing-Bablok coefficient A 0.58, 95% CI −2.42 to 3.53; coefficient B 0.90, 95% CI −0.74 to 1.07). The reproducibility of IMR was excellent with both adenosine and papaverine (ICC 0.78, 95% CI 0.63 to 0.88 and ICC 0.93, 95% CI 0.87 to 0.97). The time needed for microvascular assessment was significantly shortened by the use of IC papaverine (3.23 (2.84, 3.78) mins vs. 5.48 (4.94, 7.09) mins, ). Conclusion. IMR can be reliably measured using IC papaverine with similar results compared to intravenous infusion of adenosine with increased reproducibility and reduced procedural time. This approach simplifies the invasive assessment of the coronary microcirculation in the catheterization laboratory.

中文翻译：

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微血管阻力指数的简化评估

背景。验证用于计算微血管阻力 (IMR) 指数的简化侵入性方法。方法。这是一项针对慢性冠状动脉综合征患者的前瞻性单中心研究，这些患者表现为非阻塞性冠状动脉疾病。IMR 是使用静脉内 (IV) 腺苷和冠状动脉内 (IC) 罂粟碱获得的。每个 IMR 测量均获得一式两份。主要目标是在使用腺苷和罂粟碱获得的 IMR 之间达成一致。次要目标包括 IMR 的再现性和 IMR 测量所需的时间。结果. 在 29 名患者中进行了 116 次 IMR 测量。平均年龄为 68.8 ± 7.24 岁，27.6% 为糖尿病患者。罂粟碱和腺苷的 IMR 值相似（17.7 ± 7.26 和 20.1 ± 8.6，; Passing-Bablok 系数 A 0.58，95% CI -2.42 至 3.53；系数 B 0.90，95% CI -0.74 至 1.07）。腺苷和罂粟碱的 IMR 重现性非常好（ICC 0.78，95% CI 0.63 至 0.88 和 ICC 0.93，95% CI 0.87 至 0.97）。使用 IC 罂粟碱显着缩短了微血管评估所需的时间（3.23 (2.84, 3.78) 分钟 vs. 5.48 (4.94, 7.09) 分钟，）。 结论。与静脉输注腺苷相比，使用 IC 罂粟碱可以可靠地测量 IMR，结果相似，可重复性更高，程序时间更短。这种方法简化了导管实验室中冠状动脉微循环的侵入性评估。