Work

Angiography-derived index of microcirculatory resistance as a novel tool to assess coronary microvascular dysfunction in patients with diabetic cardiomyopathy

Year: 2025

Type: article

Abstract: BACKGROUNDS: Coronary microvascular dysfunction (CMD) has been proposed as a major mechanism and a potential therapeutic target for diabetic cardiomyopathy (DbCM); however, it has not been fully investigated in a clinical setting. The angiography-derived index of microcirculatory resistance (AMR) is a novel non-invasive measurement of CMD that exhibits promising clinical applications. METHODS: AMR was measured in hospitalized patients with DbCM and in control patients. The incidence, clinical characteristics, risk factors, and effects of pharmacological interventions on CMD were investigated. RESULTS: AMR was significantly higher in patients who met the DbCM-2B diagnostic criteria. The independent risk factors for abnormal AMR included diabetes, body mass index (BMI), and N-terminal pro-brain natriuretic peptide (NT-pro-BNP). Patients with elevated NT-pro-BNP had high AMR, and those grouped by medication indicated that ACEI/ARB, sacubitril/valsartan, and trimetazidine might lower AMR in patients with elevated NT-pro-BNP. CONCLUSIONS: The DbCM-2B diagnostic criteria demonstrated a strong correlation with CMD. ACEI/ARB, sacubitril/valsartan, and trimetazidine might improve CMD in patients with DbCM.

Source: International Journal of Cardiology

DOI: 10.1016/j.ijcard.2025.133220