Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain.
Catheter Cardiovasc Interv. 2022 Jun;99(7):2018-2025. doi: 10.1002/ccd.30174. Epub 2022 Apr 2.
The index of microvascular resistance (IMR) is an established tool to assess the status of coronary microcirculation. However, the need for a pressure wire and hyperemic agents have limited its routine use and have led to the development of angiography-derived pressure-wire-free methods (angiography-derived IMR [IMRAngio]). In this review and meta-analysis, we aim to assess the global diagnosis accuracy of IMRAngio versus IMR.
A systematic review of the literature was performed. Studies directly evaluating IMRAngio versus IMR were considered eligible. Pooled values of diagnostic test and summary receiver operator curve were calculated.
Seven studies directly comparing IMRAngio versus IMR were included (687 patients; 807 vessels). Pooled sensitivity, specificity, +likelihood ratio (LR), and -LR were 82%, 83%, 4.5, and 0.26 respectively. Pooled accuracy was 83% while pooled positive predictive value and negative predictive value were 76% and 85%, respectively. Comparable results were obtained when analyzing by clinical scenario (acute and nonacute coronary syndromes).
IMRAngio shows a good diagnostic performance for the prediction of abnormal IMR.
微血管阻力指数（IMR）是评估冠状动脉微循环状态的一种既定工具。然而，需要压力导丝和扩血管药物的特性限制了其常规使用，并导致了无压力导丝的血管造影衍生方法（血管造影衍生 IMR [IMRAngio]）的发展。在本次综述和荟萃分析中，我们旨在评估与 IMR 相比，IMRAngio 的全球诊断准确性。
进行了系统的文献回顾。直接评估 IMRAngio 与 IMR 的研究被认为符合条件。计算了诊断测试的汇总值和综合接收者操作曲线。
纳入了 7 项直接比较 IMRAngio 与 IMR 的研究（687 例患者；807 支血管）。汇总的敏感性、特异性、+似然比（LR）和 -LR 分别为 82%、83%、4.5 和 0.26。汇总的准确性为 83%，而汇总的阳性预测值和阴性预测值分别为 76%和 85%。当按临床情况（急性和非急性冠状动脉综合征）进行分析时，得到了类似的结果。
IMRAngio 对异常 IMR 的预测具有良好的诊断性能。
