Abstract
The dysfunction of coronary microcirculation is an important cause of coronary artery disease (CAD). The index of microcirculatory resistance (IMR) is a quantitative evaluation of coronary microcirculatory function, which provides a significant reference for the prediction, diagnosis, treatment, and prognosis of CAD. IMR also plays a key role in investigating the interaction between epicardial and microcirculatory dysfunctions, and is closely associated with coronary hemodynamic parameters such as flow rate, distal coronary pressure, and aortic pressure, which have been widely applied in computational studies of CAD. However, there is currently a lack of consensus across studies on the normal and pathological ranges of IMR. The relationships between IMR and coronary hemodynamic parameters have not been accurately quantified, which limits the application of IMR in computational CAD studies. In this paper, we discuss the research gaps between IMR and its potential applications in the computational simulation of CAD. Computational simulation based on the combination of IMR and other hemodynamic parameters is a promising technology to improve the diagnosis and guide clinical trials of CAD.
概要
冠状动脉微循环功能异常是冠状动脉疾病 (CAD) 发生的重要原因. 微循环阻力指数 (IMR) 是定量评价冠状动脉微循环功能的指标, 为冠状动脉疾病的早期预测、 诊断、 治疗及预后提供了重要参考. IMR在研究心外膜和微循环功能障碍之间的相互作用方面起着关键作用, 并与一些血流动力学参数 (例如流速、 远端冠脉压力和主动脉压力) 密切相关, 这些参数已广泛应用于CAD的计算研究. 然而, 目前IMR的正常范围与病理范围缺乏一致性. IMR与其他血流动力学参数之间的关系尚未被准确量化, 这限制了IMR在CAD计算研究中的应用. 在这篇文章中, 我们讨论了IMR与CAD计算仿真方面的研究空白和应用潜力. 在未来, 将IMR与其他血流动力学结合应用在计算模拟中, 有望提高CAD诊断水平以及为相关临床实验提供重要参考.
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This work was supported by the Natural Science Foundation of China (Nos. 61527811 and 61701435), the Key Research and Development Program of Zhejiang Province (No. 2020C03016), the Zhejiang Provincial Natural Science Foundation of China (No. LY17H180003), and the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (No. 2020RC094), China.
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Yingyi GENG and Xintong WU searched the literature. Yingyi GENG and Haipeng LIU drafted the manuscript. Haipeng LIU, Dingchang ZHENG, and Ling XIA contributed to the revision of this manuscript. Dingchang ZHENG and Ling XIA contributed the framework of the manuscript. All authors have read and approved the final manuscript.
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Yingyi GENG, Xintong WU, Haipeng LIU, Dingchang ZHENG, and Ling XIA declare that they have no conflict of interest.
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Geng, Y., Wu, X., Liu, H. et al. Index of microcirculatory resistance: state-of-the-art and potential applications in computational simulation of coronary artery disease. J. Zhejiang Univ. Sci. B 23, 123–140 (2022). https://doi.org/10.1631/jzus.B2100425
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DOI: https://doi.org/10.1631/jzus.B2100425