Abstract
Coronary microvascular dysfunction is present in the majority of patients with acute coronary syndromes, myocardial infarction with nonobstructive coronary arteries, and takotsubo syndrome. Assessment of the coronary microcirculation via a noninvasive index of coronary microvascular resistance (CMVR) based on coronary angiography is currently employed by many laboratories (AngioMVR). A proposal is presented herein of a new index of CMVR, based on the duration of the transient ECG repolarization changes during coronary angiography (ECGMVR), well known to occur in patients with and without coronary artery disease, and specific for the left and right coronary artery contrast injections, which have been widely documented, starting 60 years ago. It will be imperative for the index of ECGMVR to be correlated with the currently implemented AngioMVR and the TIMI frame count index, for the validation of the ECGMVR.
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