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Original Article

Thermodilution-Derived Coronary Microvascular Resistance and Flow Reserve in Patients With Cardiac Syndrome X

Chufan Luo, Ming Long, Xun Hu, Zhibin Huang, Chengheng Hu, Xiuren Gao, Zhimin Du
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https://doi.org/10.1161/CIRCINTERVENTIONS.113.000953
Circulation: Cardiovascular Interventions. 2014;CIRCINTERVENTIONS.113.000953
Originally published January 7, 2014
Chufan Luo
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Ming Long
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Xun Hu
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Zhibin Huang
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Chengheng Hu
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Xiuren Gao
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Zhimin Du
From the Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Abstract

Background—Although increased coronary microvascular resistance (CMR), resulting in coronary microvascular dysfunction, is speculated to be responsible for myocardial ischemia in patients with cardiac syndrome X (CSX), it has never been directly demonstrated, and the correlation between CMR and severity of myocardial ischemia has not been elucidated in this setting. This study aimed to ascertain the increased CMR directly and to explore the relationship between CMR and severity of ischemia in patients with CSX.

Methods and Results—We studied 18 patients with CSX and 18 age- and sex-matched control subjects. Thermodilution-derived coronary flow reserve and index of microvascular resistance were measured using a pressure–temperature sensor-tipped coronary wire. Exercise treadmill test was performed by the Bruce protocol for calculating Duke treadmill score. Coronary flow reserve was significantly lower (2.37±0.81 versus 3.68±0.72; P<0.001) and index of microvascular resistance was higher (33.1±7.9 versus 18.8±5.6 U; P<0.001) in patients with CSX compared with those in control subjects. The Duke treadmill score was correlated positively to coronary flow reserve (r=0.539; P=0.021) and negatively to index of microvascular resistance (r=−0.742; P<0.001) in patients with CSX.

Conclusions—Using an intracoronary thermodilution method, we for the first time directly demonstrated an increased microvascular resistance in patients with CSX. Furthermore, severity of ischemia was found to be intimately associated with CMR in this setting.

  • cardiac syndrome X
  • microvascular angina
  • Received September 12, 2013.
  • Accepted November 26, 2013.
  • © 2014 American Heart Association, Inc.
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Circulation: Cardiovascular Interventions
April 2018, Volume 11, Issue 4
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    Thermodilution-Derived Coronary Microvascular Resistance and Flow Reserve in Patients With Cardiac Syndrome X
    Chufan Luo, Ming Long, Xun Hu, Zhibin Huang, Chengheng Hu, Xiuren Gao and Zhimin Du
    Circulation: Cardiovascular Interventions. 2014;CIRCINTERVENTIONS.113.000953, originally published January 7, 2014
    https://doi.org/10.1161/CIRCINTERVENTIONS.113.000953

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    Thermodilution-Derived Coronary Microvascular Resistance and Flow Reserve in Patients With Cardiac Syndrome X
    Chufan Luo, Ming Long, Xun Hu, Zhibin Huang, Chengheng Hu, Xiuren Gao and Zhimin Du
    Circulation: Cardiovascular Interventions. 2014;CIRCINTERVENTIONS.113.000953, originally published January 7, 2014
    https://doi.org/10.1161/CIRCINTERVENTIONS.113.000953
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