In general, IMR values below 25 are considered normal and were consistently found in validation cohorts of healthy populations with normal valves. Values over 25 reflect elevated microvascular resistance. After STEMI, patients with high IMR values (>40) are more likely to have raised cardiac enzymes, less cardiac recovery on non‐invasive imaging and evidence of microvascular obstruction on magnetic resonance imaging. In more stable patients, values over 25 suggest microvascular dysfunction and are associated with higher rates of cardiovascular presentation and suggest a microvascular cause of patient’s angina. IMR measurement can be combined with other vasoreactivity testing for a comprehensive testing in the cardiac catheter laboratory.
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology
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