{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:51:58Z","timestamp":1793620318053,"version":"4.5.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"30","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The microvascular resistance reserve (MRR) was introduced as a means to characterize the vasodilator reserve capacity of the coronary microcirculation while accounting for the influence of concomitant epicardial disease and the impact of administration of potent vasodilators on aortic pressure. This study aimed to evaluate the diagnostic and prognostic performance of MRR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 1481 patients with stable symptoms and a clinical indication for coronary angiography were included from the global ILIAS Registry. MRR was derived as a function of the coronary flow reserve (CFR) divided by the fractional flow reserve (FFR) and corrected for driving pressure. The median MRR was 2.97 [Q1\u2013Q3: 2.32\u20133.86] and the overall relationship between MRR and CFR was good [correlation coefficient (Rs) = 0.88, P &amp;lt; 0.005]. The difference between CFR and MRR increased with decreasing FFR [coefficient of determination (R2) = 0.34; Coef.\u20142.88, 95% confidence interval (CI): -3.05\u2013\u22122.73; P &amp;lt; 0.005]. MRR was independently associated with major adverse cardiac events (MACE) at 5-year follow-up [hazard ratio (HR) 0.78; 95% CI 0.63\u20130.95; P = 0.024] and with target vessel failure (TVF) at 5-year follow-up (HR 0.83; 95% CI 0.76\u20130.97; P = 0.047). The optimal cut-off value of MRR was 3.0. Based on this cut-off value, only abnormal MRR was significantly associated with MACE and TVF at 5-year follow-up in vessels with functionally significant epicardial disease (FFR &amp;lt;0.75).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRR seems a robust indicator of the microvascular vasodilator reserve capacity. Moreover, in line with its theoretical background, this study suggests a diagnostic advantage of MRR over other indices of vasodilatory capacity in patients with hemodynamically significant epicardial coronary artery disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehad378","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T07:25:10Z","timestamp":1684999510000},"page":"2862-2869","source":"Crossref","is-referenced-by-count":102,"title":["Microvascular resistance reserve: diagnostic and prognostic performance in the ILIAS registry"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1515-9623","authenticated-orcid":false,"given":"Coen K M","family":"Boerhout","sequence":"first","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Samsung Medical Center, Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute , 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guus A","family":"de Waard","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hernan","family":"Mejia-Renteria","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IDISSC, and Universidad Complutense de Madrid , Calle del Prof Mart\u00edn Lagos, S\/N, 28040 Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital , 42 Jebong-ro, Dong-gu, Gwangju , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Jung","sequence":"additional","affiliation":[{"name":"Sejong General Hospital, Sejong Heart Institute , 20 Gyeyangmunhwa-ro, Gyeyang-gu, Incheon , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Center , 4 Chome-14-4 Yabutaminami, Gifu, 500-8384 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Echavarria-Pinto","sequence":"additional","affiliation":[{"name":"Hospital General ISSSTE Quer\u00e9taro\u2014Facultad de Medicina, Universidad Aut\u00f3noma de Quer\u00e9taro , Av Tecnol\u00f3gico 101, Las Campanas, 76000 Santiago de Quer\u00e9taro , M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Meuwissen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amphia Hospital , Molengracht 21, 4818 CK Breda , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Center , 4 Chome-14-4 Yabutaminami, Gifu, 500-8384 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Madera-Cambero","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tergooi Hospital , Laan van Tergooi 2, 1212 VG Hilversum , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan","family":"Eftekhari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Blvd. 161, 8200 Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A","family":"Effat","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Health and Diseases, Department of Internal Medicine, University of Cincinnati , 231 Albert Sabin Way, Cincinnati, OH 45229 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Murai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tsuchiura Kyodo General Hospital , 4 Chome-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Tsuchiura city , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Marques","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Hyung","family":"Doh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Inje University Ilsan Paik Hospital , 170 Juhwa-ro, Ilsanseo-gu, Goyangsi, Gyeonggi-do, Goyang , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evald H","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Blvd. 161, 8200 Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupak","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Mechanical and Materials Engineering Department, University of Cincinnati , 2901 Woodside Drive, Cincinnati, OH 45219 , USA"},{"name":"Research Services, Veteran Affairs Medical Center , 3200 Vine St, Cincinnati, OH 45220 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Keimyung University , 1095 Dalgubeol-daero, Sindang-dong, Dalseo-gu, Daegu , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-6262","authenticated-orcid":false,"given":"Giampaolo","family":"Niccoli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Institute of Cardiology , 296-12 Changgyeonggung-ro, Jongno-gu, Seoul, Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Center , 4 Chome-14-4 Yabutaminami, Gifu, 500-8384 , Japan"},{"name":"Cardiovascular Center, Toda Central General Hospital , 1 Chome-19-3 Honcho, Toda, Saitama 335-0023, Toda , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Medical University Hachioji Medical Center , 1163 Tatemachi, Hachioji, Tokyo 193-0998 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9169-6968","authenticated-orcid":false,"given":"Eun-Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine , Zuid-Korea, Ulsan, Dong-gu 25 , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-7105","authenticated-orcid":false,"given":"Yolande","family":"Appelman","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel A M","family":"Beijk","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6136-8640","authenticated-orcid":false,"given":"Niels","family":"van Royen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud University Medical Centre , Geert Grooteplein Zuid 10, 6525 GA Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8038-7898","authenticated-orcid":false,"given":"Paul","family":"Knaapen","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4932-0112","authenticated-orcid":false,"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IDISSC, and Universidad Complutense de Madrid , Calle del Prof Mart\u00edn Lagos, S\/N, 28040 Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-5292","authenticated-orcid":false,"given":"Tsunekazu","family":"Kakuta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tsuchiura Kyodo General Hospital , 4 Chome-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028, Tsuchiura city , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bon Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital , 101 Daehak-ro, Yeongeon-dong, Jongno-gu, Seoul , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J","family":"Piek","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim P","family":"van de Hoef","sequence":"additional","affiliation":[{"name":"Heart Center, Amsterdam UMC , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"},{"name":"Department of Cardiology, University Medical Centre Utrecht , Heidelberglaan 100, 3584 CX Utrecht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"2023080717511717600_ehad378-B1","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1093\/eurheartj\/eht513","article-title":"Coronary microvascular dysfunction: an update","volume":"35","author":"Crea","year":"2014","journal-title":"Eur Heart J"},{"key":"2023080717511717600_ehad378-B2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/nrcardio.2014.160","article-title":"Coronary microvascular dysfunction: mechanisms and functional assessment","volume":"12","author":"Camici","year":"2015","journal-title":"Nat Rev Cardiol"},{"key":"2023080717511717600_ehad378-B3","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1161\/CIRCULATIONAHA.119.041595","article-title":"Coronary microvascular dysfunction is associated with myocardial ischemia and abnormal coronary perfusion during exercise","volume":"140","author":"Rahman","year":"2019","journal-title":"Circulation"},{"key":"2023080717511717600_ehad378-B4","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1016\/j.jacc.2018.09.006","article-title":"Stratified medical therapy using invasive coronary function testing in angina","volume":"72","author":"Ford","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2023080717511717600_ehad378-B5","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/cvr\/cvaa002","article-title":"Experimental animal models of coronary microvascular dysfunction","volume":"116","author":"Sorop","year":"2020","journal-title":"Cardiovasc Res"},{"key":"2023080717511717600_ehad378-B6","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1114\/1.1308503","article-title":"Problems of coronary flow reserve","volume":"28","author":"Hoffman","year":"2000","journal-title":"Ann Biomed Eng"},{"key":"2023080717511717600_ehad378-B7","doi-asserted-by":"crossref","first-page":"9971874","DOI":"10.1155\/2021\/9971874","article-title":"Simplified assessment of the index of microvascular resistance","volume":"2021","author":"Kodeboina","year":"2021","journal-title":"J Interv Cardiol"},{"key":"2023080717511717600_ehad378-B8","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1016\/j.jacc.2021.08.017","article-title":"Microvascular resistance reserve for assessment of coronary microvascular function","volume":"78","author":"De Bruyne","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2023080717511717600_ehad378-B9","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1016\/j.jcin.2015.04.028","article-title":"Intracoronary adenosine: dose-response relationship with hyperemia","volume":"8","author":"Adjedj","year":"2015","journal-title":"JACC Cardiovasc Interv"},{"key":"2023080717511717600_ehad378-B10","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1093\/eurheartj\/eht040","article-title":"Safety and efficacy of a novel hyperaemic agent, intracoronary nicorandil, for invasive physiological assessments in the cardiac catheterization laboratory","volume":"34","author":"Jang","year":"2013","journal-title":"Eur Heart J"},{"key":"2023080717511717600_ehad378-B11","doi-asserted-by":"crossref","first-page":"2676","DOI":"10.1002\/sim.4509","article-title":"Classification accuracy and cut point selection","volume":"31","author":"Liu","year":"2012","journal-title":"Stat Med"},{"key":"2023080717511717600_ehad378-B12","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jcin.2012.08.019","article-title":"Calculation of the index of microcirculatory resistance without coronary wedge pressure measurement in the presence of epicardial stenosis","volume":"6","author":"Yong","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"key":"2023080717511717600_ehad378-B13","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.1016\/j.jacc.2010.01.054","article-title":"Coronary microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia","volume":"55","author":"Pepine","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2023080717511717600_ehad378-B14","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.jcmg.2020.09.034","article-title":"Long-term prognosis of patients with coronary microvascular disease using stress perfusion cardiac magnetic resonance","volume":"14","author":"Zhou","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023080717511717600_ehad378-B15","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jcmg.2016.02.003","article-title":"Imaging microvascular dysfunction and mechanisms for female-male differences in CAD","volume":"9","author":"Patel","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023080717511717600_ehad378-B16","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.atherosclerosis.2012.05.034","article-title":"Coronary microvascular dysfunction is associated with higher frequency of thin-cap fibroatheroma","volume":"223","author":"Dhawan","year":"2012","journal-title":"Atherosclerosis"},{"key":"2023080717511717600_ehad378-B17","doi-asserted-by":"crossref","first-page":"719","DOI":"10.4244\/EIJ-D-22-00043","article-title":"Prognostic value of structural and functional coronary microvascular dysfunction in patients with non-obstructive coronary artery disease; from the multicentre international ILIAS registry","volume":"18","author":"Boerhout","year":"2022","journal-title":"EuroIntervention"},{"key":"2023080717511717600_ehad378-B18","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.jcin.2022.03.016","article-title":"Combined assessment of FFR and CFR for decision making in coronary revascularization","volume":"15","author":"van de Hoef","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2023080717511717600_ehad378-B19","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1016\/j.jcin.2018.07.011","article-title":"Doppler flow velocity and thermodilution to assess coronary flow reserve: a head-to-head comparison with [15O]H2O PET","volume":"20","author":"Everaars","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2023080717511717600_ehad378-B20","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.jcin.2022.03.015","article-title":"Comparison of Doppler flow velocity and thermodilution derived indexes of coronary physiology","volume":"15","author":"Demir","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2023080717511717600_ehad378-B21","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jcin.2020.12.037","article-title":"Basics of coronary thermodilution","volume":"14","author":"Candreva","year":"2021","journal-title":"JACC Cardiovasc Interv"}],"container-title":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/44\/30\/2862\/51048629\/ehad378.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/44\/30\/2862\/51048629\/ehad378.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T13:51:35Z","timestamp":1691416295000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/44\/30\/2862\/7205678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,23]]},"references-count":21,"journal-issue":{"issue":"30","published-online":{"date-parts":[[2023,6,23]]},"published-print":{"date-parts":[[2023,8,7]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehad378","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8,7]]},"published":{"date-parts":[[2023,6,23]]}}}