{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:39:52Z","timestamp":1792291192828,"version":"4.4.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Microvascular obstruction (MVO) is associated with heart failure (HF) following ST-segment\u2013elevation myocardial infarction. Angiography-derived microcirculatory resistance (AMR), a wire- and adenosine-free measure, may facilitate early assessment of microvascular function post-primary percutaneous coronary intervention. This study aimed to evaluate the ability of AMR to detect MVO and its prognostic value for predicting HF in patients with ST-segment\u2013elevation myocardial infarction post-primary percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients with consecutive ST-segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention with a cardiac magnetic resonance examination 2 to 7 days post-procedure between April 2016 and February 2023 were retrospectively reviewed. AMR was computed from coronary angiography. MVO was identified and quantified via cardiac magnetic resonance. The end point was new-onset HF during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Overall, 475 patients (aged 56.8\u00b111.7 years; 399 men) were included. The area under the curve for AMR to detect MVO was 0.821 (95% CI, 0.782\u20130.859), with an optimal cutoff value of 2.7 mm\u2009Hg*s\/cm. During a median follow-up of 37.3 months, 121 (25.5%) patients developed HF. AMR, whether as a continuous (per 0.5-mm\u2009Hg*s\/cm increase; hazard ratio, 1.29 [95% CI, 1.10\u20131.52];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002) or categorical (AMR &gt;2.7 mm\u2009Hg*s\/cm; hazard ratio, 2.15 [95% CI, 1.43\u20133.22];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) variable, was independently associated with HF after adjusting for traditional risk factors (age, symptom-to-balloon time, left anterior descending coronary artery, and ejection fraction) and late gadolinium enhancement-cardiac magnetic resonance parameters. AMR improved prognostication over traditional risk factors and late gadolinium enhancement-cardiac magnetic resonance parameters (net reclassification improvement, 0.533;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001; integrative discrimination index, 0.023;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>AMR showed good diagnostic performance in detecting MVO and was an independent and incremental predictor of HF in patients with ST-segment\u2013elevation myocardial infarction post-primary percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circimaging.124.017506","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T05:05:38Z","timestamp":1743656738000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Angiography-Derived Microcirculatory Resistance in Detecting Microvascular Obstruction and Predicting Heart Failure After STEMI"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-3500","authenticated-orcid":true,"given":"Guanyu","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Interventional Diagnosis and Treatment (G.L., K.H., Z.L., X.M.), Beijing Anzhen Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0619-6038","authenticated-orcid":true,"given":"Lei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Radiology 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Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency Coronary Artery Unit (H.G.), Beijing Anzhen Hospital, Capital Medical University, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1259-0119","authenticated-orcid":true,"given":"Xiaohai","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Interventional Diagnosis and Treatment (G.L., K.H., Z.L., X.M.), Beijing Anzhen Hospital, Capital Medical University, 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