微循环阻力指数在心血管疾病中的应用

随着医疗水平的发展,心血管疾病的诊断和治疗越来越规范和细致,不仅需要对心脏大血管进行评估,对微循环的评估也是十分重要。微循环阻力指数(index of microcirculatory resistance,IMR)是2003年由Fearon医生提出的一种操作方便、能真实反映微循环阻力的冠状动脉功能学定量评价指标。IMR的可重复性好,且不受冠状动脉狭窄影响,在预测围手术期心梗、PCI术后微血管阻塞、ST段抬高性心肌梗死患者PCI预后,评价PCI辅助治疗手段的有效性,阐明应激性心肌病的发病机制以及评价心血管药物的应用等方面具有重要意义。本文就IMR的特点及临床应用做一综述。

The Application of Index of Microcirculation Resistance in Cardiovascular Disease

With improvements in healthcare, the diagnosis and treatment of cardiovascular diseases are becoming more and more specific and detailed. Though it is critical to evaluate large blood vessels of heart, importance of microcirculation accessment is increasingly valued. The concept of index of microcirculatory resistance (IMR) is raised by Dr. Fearon in 2003. IMR is a convenient quantitative evaluation index that can actually reflect microcirculatory resistance, and not influenced by coronary artery stenosis. IMR has the advantage of great reproducibility. This gives IMR a major value in predicting perioperative myocardial infarction, post-PCI microvascular obstruction and prognosis of PCI patients with ST segment elevation myocardial infarction. Meanwhile, It also plays an important role in evaluating auxiliary treatment of PCI, elucidating the pathogenesis of stress-induced cardiomyopathy and evaluating cardiovascular drugs. This review discusses the features of IMR and its clinical applications.