Key result
Invasive measurement of the index of microcirculatory resistance (IMR) demonstrated significant microcirculatory dysfunction in a patient with takotsubo cardiomyopathy.
Case Report (n=1)
This case report provides the first invasive documentation of microcirculatory dysfunction in takotsubo cardiomyopathy using the index of microcirculatory resistance (IMR).
May indicate microcirculatory dysfunction in takotsubo cardiomyopathy; leaves open whether IMR informs diagnosis or management.
We report a patient who presents with acute chest pain and positive cardiac enzymes clinically consistent with an acute coronary syndrome (ACS). Coronary angiography revealed normal epicardial arteries and the left ventriculogram was notable for apical ballooning. This was strongly suggestive of takotsubo cardiomyopathy. Pressure wire measurements of Fractional flow reserve (FFR) and IMR demonstrated a normal FFR, but significant microcirculatory dysfunction. This is the first such case that documents this abnormality invasively using the IMR, which unlike CFR is specific for the microcirculation and reproducible through a range of hemodynamic states.
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Daniels et al. (2010) conducted a case report in Takotsubo cardiomyopathy (n=1). Index of microcirculatory resistance (IMR) was evaluated on Microcirculatory dysfunction. Invasive measurement of the index of microcirculatory resistance (IMR) demonstrated significant microcirculatory dysfunction in a patient with takotsubo cardiomyopathy.
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