Homogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease
Authors' conclusion
In most ANOCA patients, microvascular function is homogeneously distributed across the three major coronary territories. Single-artery testing may suffice in many cases, aligning with guidelines. However, some patients exhibit notable inter-territorial variation, suggesting that multi-vessel evaluation may be prudent in borderline scenarios.
Study context
- Population
- Symptomatic ANOCA patients with [15O]H2O positron emission tomography (PET) and three-vessel invasive fractional flow reserve (FFR)patients, 465 vessels
- Participants
- 155 patients
- Comparison
- Microvascular resistance reserve (MRR) across the three main coronary branches
Primary result
As reported in the abstract
MRR (all vessels)
3.92 ± 1.21
Further findings
Correlations in MRR among the three coronary branches
- R
- 0.76 to 0.86
Mean difference between MRR measurements in different arteries
- Mean difference
- 2.4 to 7.5%
- Without any consistent directional bias
Intra-class correlation coefficient for absolute agreement
- Overall ICC
- 0.80 (95% CI: 0.74-0.85)
- Indicating good single-measure reliability
Diagnostic concordance of coronary microvascular dysfunction (CMD) (MRR ≤3.0) across the three vessels
- Patients with concordance
- ≈80% (123/155)
Original publication
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