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Biomedicines
Volume 13
Issue 2
10.3390/biomedicines13020466
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Article

Relationship Between Noninvasive Doppler-Derived Coronary Flow Reserve Measured by Transthoracic Echocardiography and Angiography Thermodilution-Measured Coronary Flow Reserve and the Index of Microcirculatory Resistance in Patients with Non-Obstructive Coronary Arteries

by
Milenko Čanković
1,2,*,
Aleksandra Milovančev
1,2,
Snežana Tadić
1,2,
Maja Stefanović
1,2,
Milovan Petrović
1,2,
Mila Kovačević
1,2,
Igor Tomas
2,
Dragana Dabović
1,2,
Vladimir Ivanović
1,2,
Aleksandra Ilić
1,2,
Anastazija Stojšić-Milosavljević
1,2,
Snežana Stojšić
2,
Nikola Komazec
1,2,
Bojan Mihajlović
1,2 and
Igor Ivanov
1,2
1
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
2
Institute for Cardiovascular Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(2), 466; https://doi.org/10.3390/biomedicines13020466
Submission received: 5 January 2025 / Revised: 5 February 2025 / Accepted: 12 February 2025 / Published: 14 February 2025
(This article belongs to the Special Issue Microcirculation in Health and Diseases)
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Abstract

Background/Objectives: Coronary microvascular dysfunction (CMD) is emerging as a critical factor in patients presenting with anginal symptoms without obstructive coronary artery disease (CAD). This study aims to investigate the relationship between invasive measurements of coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) using thermodilution techniques, compared to non-invasive assessments of CFR with transthoracic Doppler echocardiography (TDE). Methods: In this observational prospective cross-sectional study, a total of 49 patients, clinically characterized as having angina with no obstructive CAD (ANOCA) or ischemia with no obstructive CAD (INOCA), underwent both TDE and invasive coronary angiography (ICA) followed by thermodilution assessment of CFR and IMR. Results: It was found that there is a statistically significant negative correlation between both non-invasive and invasive CFR measurements and IMR. Specifically, a negative moderate correlation was observed between non-invasive CFR and IMR (rs = −0.477, p < 0.01), as well as a high negative correlation between invasive CFR and IMR (r = −0.541, p < 0.01). Receiver operating characteristic (ROC) analysis indicated that both non-invasive and invasive CFRs are effective predictors of CMD, defined as IMR > 25. Conclusions: Both noninvasive and invasive CFR measurements are significant independent predictors of CMD. Our results indicate that noninvasive TDE CFR can be a reliable tool for assessing CMD in patients with ANOCA, potentially facilitating earlier diagnosis and management strategies for this patient population.
Keywords: coronary flow reserve; index of microvascular resistance; transthoracic Doppler echocardiography; coronary microvascular dysfunction; microvascular angina coronary flow reserve; index of microvascular resistance; transthoracic Doppler echocardiography; coronary microvascular dysfunction; microvascular angina

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MDPI and ACS Style

Čanković, M.; Milovančev, A.; Tadić, S.; Stefanović, M.; Petrović, M.; Kovačević, M.; Tomas, I.; Dabović, D.; Ivanović, V.; Ilić, A.; et al. Relationship Between Noninvasive Doppler-Derived Coronary Flow Reserve Measured by Transthoracic Echocardiography and Angiography Thermodilution-Measured Coronary Flow Reserve and the Index of Microcirculatory Resistance in Patients with Non-Obstructive Coronary Arteries. Biomedicines 2025, 13, 466. https://doi.org/10.3390/biomedicines13020466

AMA Style

Čanković M, Milovančev A, Tadić S, Stefanović M, Petrović M, Kovačević M, Tomas I, Dabović D, Ivanović V, Ilić A, et al. Relationship Between Noninvasive Doppler-Derived Coronary Flow Reserve Measured by Transthoracic Echocardiography and Angiography Thermodilution-Measured Coronary Flow Reserve and the Index of Microcirculatory Resistance in Patients with Non-Obstructive Coronary Arteries. Biomedicines. 2025; 13(2):466. https://doi.org/10.3390/biomedicines13020466

Chicago/Turabian Style

Čanković, Milenko, Aleksandra Milovančev, Snežana Tadić, Maja Stefanović, Milovan Petrović, Mila Kovačević, Igor Tomas, Dragana Dabović, Vladimir Ivanović, Aleksandra Ilić, and et al. 2025. "Relationship Between Noninvasive Doppler-Derived Coronary Flow Reserve Measured by Transthoracic Echocardiography and Angiography Thermodilution-Measured Coronary Flow Reserve and the Index of Microcirculatory Resistance in Patients with Non-Obstructive Coronary Arteries" Biomedicines 13, no. 2: 466. https://doi.org/10.3390/biomedicines13020466

APA Style

Čanković, M., Milovančev, A., Tadić, S., Stefanović, M., Petrović, M., Kovačević, M., Tomas, I., Dabović, D., Ivanović, V., Ilić, A., Stojšić-Milosavljević, A., Stojšić, S., Komazec, N., Mihajlović, B., & Ivanov, I. (2025). Relationship Between Noninvasive Doppler-Derived Coronary Flow Reserve Measured by Transthoracic Echocardiography and Angiography Thermodilution-Measured Coronary Flow Reserve and the Index of Microcirculatory Resistance in Patients with Non-Obstructive Coronary Arteries. Biomedicines, 13(2), 466. https://doi.org/10.3390/biomedicines13020466

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