Precision diagnostics is the premise of scientific treatment. Microcirculation plays a crucial role in the supply and regulation of myocardial blood flow. It is a potential inducer and independent predictor of various types of coronary heart disease. The traditional method of microcirculation assessment has various limitations, which makes it impossible to be widely used in clinical practice. As one of the optimal ways to achieve precise diagnosis and treatment of vascular diseases, the diagnosis of coronary microcirculation dysfunctions has been clinically ignored due to the difficulty in assessment. To address this issue, RainMed Medical has pioneered the world's first non-invasive coronary microcirculation diagnosis system, caIMR, which has expanded non-invasive microcirculation diagnosis technology and brings new opportunities for the diagnosis and treatment of complex cardiovascular diseases in clinical practice.

From the proposal of the technology to its application, the caIMR system has continuously attracted the attention and research of top experts and scholars at home and abroad, and has continuously unlocked the potential clinical value of itself, providing a convenient and practical clinical indicator for the evaluation of high-risk pathogenic factors of coronary heart disease and the diagnosis of complex coronary artery diseases. Currently, with the increasing popularity of caIMR research, and abundant research results are continuously included in internationally renowned high-level SCI journals, laying a solid theoretical foundation for the large-scale application of caIMR. The following are the academic achievements of the caIMR system since the beginning of 2023, which involve the demonstration of the diagnostic performance of caIMR and the prediction and assessment of common types of diseases such as stable angina pectoris, acute myocardial infarction, dilated cardiomyopathy, and preserved ejection fraction heart failure. It is hoped that new ideas and diagnostic methods for clinical diagnosis and treatment of vascular diseases can be provided.

01 The diagnostic consistency of the caIMR system is as high as 93.81%, which can be used as a substitute indicator for guidewire-derived IMR to promote large-scale clinical application.

Microcirculation dysfunction can cause ischemic symptoms in patients without Epicardial vessel occlusion. Clinical practice guidelines and consensus documents recommend measuring the index of microcirculation resistance in cases of suspected myocardial ischemia caused by microvessels. In the past, guidewire-derived IMR was used for microcirculation assessment, but it takes a lot of time with high expense. Recently, RainMed Medical has commercially launched the world's first non-invasive caIMR system, which provides a more convenient techonology for clinical assessment of coronary microcirculation.

On April 12, 2023, Academician Ge Junbo's team from Zhongshan Hospital affiliated to Fudan University published a research article on Flash III trial in the JCR Q2 journal American Heart Journal, revealing the caIMR system's diagnostic performance beyond expectations. The research results showed that the diagnostic accuracy of the caIMR system was as high as 93.81%, and it had extremely high consistency, sensitivity, and specificity. Flash III is a prospective, multicenter, randomized study and is the world's first confirmatory clinical study of a non-invasive microcirculation diagnosis system, with Academician Ge Junbo and Professor Huo Yong as co-PIs.

In terms of diagnostic performance, the research results of Flash III strongly confirmed that the caIMR system can replace guidewire-derived IMR for clinical application. In terms of operation process, the caIMR system does not require additional hyperemic agents and guidewire intervention, making it safer, simpler, and more efficient. It provides technical support for large-scale clinical application of microcirculation diagnosis and potential diagnostic indicators for the clinical diagnosis and treatment of complex cardiovascular diseases, promoting the development of precise medical treatment for vascular diseases.

Read the paper: https://doi.org/10.1016/j.ahj.2023.03.016

02 caIMR can objectively reflect the degree and evolution of postoperative infarct pathology in acute myocardial infarction patients, and maximize clinical benefits for patients.

Recently, Professor Shaoping Nie and Professor Xiao Wang from Beijing Anzhen Hospital, Capital Medical University, published a cutting-edge research article titled "Coronary angiography-derived index of microcirculatory resistance and evolution of infarct pathology after ST-segment-elevation myocardial infarction" in a top-tier journal. The study revealed the immediate diagnostic and long-term predictive value of the caIMR system for microvascular injury after primary percutaneous coronary intervention (PPCI). Microvascular obstruction (MVO) is an upstream problem and is potentially reversible, but severe microvascular injury progresses to irreversible intramyocardial haemorrhage (IMH). IMH drives infarct expansion after reperfusion and compromises myocardial salvage. This study confirmed that caIMR can objectively reflect the degree and evolution of postoperative infarct pathology in acute myocardial infarction patients, provide a risk stratification index for microcirculation injury diagnosis and treatment, and maximize clinical benefits for patients.

Previous studies published in journals such as "JACC: CARDIOVASCULAR INTERVENTIONS" and "Cardiovascular Diabetology" have confirmed the important clinical diagnostic value of the caIMR system. Among them, a clinical study published by Samsung Medical Center in the journal "Rev Esp Cardiol" preliminarily verified the feasibility of using cardiac magnetic resonance imaging to measure microcirculation injury immediately after surgery with the caIMR system. This study further revealed the relationship between the caIMR index and infarct evolution through cardiac magnetic resonance imaging, making it more clinically informative and practical.

Read the paper：https://doi.org/10.1093/ehjci/jead141