{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:19:32Z","timestamp":1791883172057,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>The index of microcirculatory resistance (IMR) is a quantitative and specific index for coronary microcirculation. However, the distribution and determinants of IMR have not been fully investigated in patients with ischemic heart disease (IHD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Consecutive patients who underwent elective measurement of both fractional flow reserve (FFR) and IMR were enrolled from 8 centers in 5 countries. Patients with acute myocardial infarction were excluded. To adjust for the influence of collateral flow, IMR values were corrected with Yong\u2019s formula (IMR\n                      <jats:sub>corr<\/jats:sub>\n                      ). High IMR was defined as greater than the 75th percentile in each of the major coronary arteries. FFR\u22640.80 was defined as an ischemic value. 1096 patients with 1452 coronary arteries were analyzed (mean age 61.1, male 71.2%). Mean FFR was 0.84 and median IMR\n                      <jats:sub>corr<\/jats:sub>\n                      was 16.6 U (Q1, Q3 12.4 U, 23.0 U). There was no correlation between IMR\n                      <jats:sub>corr<\/jats:sub>\n                      and FFR values (\n                      <jats:italic>r<\/jats:italic>\n                      =0.01,\n                      <jats:italic>P<\/jats:italic>\n                      =0.62), and the categorical agreement of FFR and IMR\n                      <jats:sub>corr<\/jats:sub>\n                      was low (kappa value=\u22120.04,\n                      <jats:italic>P<\/jats:italic>\n                      =0.10). There was no correlation between IMR\n                      <jats:sub>corr<\/jats:sub>\n                      and angiographic % diameter stenosis (\n                      <jats:italic>r<\/jats:italic>\n                      =\u22120.03,\n                      <jats:italic>P<\/jats:italic>\n                      =0.25). Determinants of high IMR were previous myocardial infarction (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.24\u20133.74,\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), right coronary artery (OR 2.09, 95% CI 1.54\u20132.84,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), female (OR 1.67, 95% CI 1.18\u20132.38,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), and obesity (OR 1.80, 95% CI 1.31\u20132.49,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). Determinants of FFR \u22640.80 were left anterior descending coronary artery (OR 4.31, 95% CI 2.92\u20136.36,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), angiographic diameter stenosis \u226550% (OR 5.16, 95% CI 3.66\u20137.28,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), male (OR 2.15, 95% CI 1.38\u20133.35,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), and age (per 10 years, OR 1.21, 95% CI 1.01\u20131.46,\n                      <jats:italic>P<\/jats:italic>\n                      =0.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>IMR showed no correlation with FFR and angiographic lesion severity, and the predictors of high IMR value were different from those for ischemic FFR value. Therefore, integration of IMR into FFR measurement may provide additional insights regarding the relative contribution of macro- and microvascular disease in patients with ischemic heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT02186093.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.115.002857","type":"journal-article","created":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T22:38:57Z","timestamp":1445639937000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":112,"title":["Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve"],"prefix":"10.1161","volume":"8","author":[{"given":"Joo Myung","family":"Lee","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Layland","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Jung","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Jung","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Echavarria-Pinto","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Watkins","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy S.","family":"Yong","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Hyung","family":"Doh","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bon-Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin K.","family":"Ng","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William F.","family":"Fearon","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith G.","family":"Oldroyd","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Seoul National University Hospital, Seoul, South Korea (J.M.L., J.-H.J., H.-J.L., B.-K.K.); Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom (J.L., S.W., K.G.O.); BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (J.L., S.W., K.G.O.); Servicio de Cardiolog\u00eda, Hospital Clinico San Carlos, Faculty of..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.111.966556"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000143893.18451.0E"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000128669.99355.CB"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-14-0364"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000298"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.04.009"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.08.062"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.603522"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.019"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408758"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht404"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.04.012"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra061889"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.012636"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.001049"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.001345"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-010-0477-1"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.070318"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.000953"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.12.011"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00436-1"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.2174\/1570161112666140423221843"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.000659"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.900191"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.19"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV5I8A158"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)90407-5"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90863-X"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-1442"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.05.034"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.115.002857","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:51:04Z","timestamp":1715554264000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.115.002857"}},"subtitle":["Insights From the International Index of Microcirculatory Resistance Registry"],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.115.002857"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.115.002857","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]},"assertion":[{"value":"2015-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e002857"}}