Intracoronary electrocardiogram detects coronary microvascular dysfunction and ischemia in patients with no obstructive coronary arteries disease
Authors' conclusion
In INOCA patients, CMD involves coronary artery territories heterogeneously. icECG can accurately detect CMD causing perfusion abnormalities in patients with INOCA outperforming physiological CMD markers, by demonstrating actual ischemia instead of predicting the likelihood of inducible ischemia based on violated surrogate thresholds of blunted flow reserve or increased minimum microvascular resistance.
Study context
- Population
- INOCA patients with ischemia proven by myocardial perfusion scan and completely normal coronary arteries
- Participants
- 21 patients60 vessels
- Comparison
- icECG-derived hyperemic indices vs Doppler-derived physiological indices (CFR, HMR) for detecting ischaemia
- Outcome
- Diagnostic performance for ischemia
Performance
As reported in the abstract
| Test or model | Cut-off | Sensitivity | Specificity | Accuracy | AUC |
|---|---|---|---|---|---|
| ∆ST | 0.10 mV | 95% | 72% | 80% | 0.860 |
| CFR | 0.623 | ||||
| HMR | 0.653 |
Cut-off
∆ST0.10 mV
CFR— not stated in the abstract
HMR— not stated in the abstract
Sensitivity
∆ST95%
CFR— not stated in the abstract
HMR— not stated in the abstract
Specificity
∆ST72%
CFR— not stated in the abstract
HMR— not stated in the abstract
Accuracy
∆ST80%
CFR— not stated in the abstract
HMR— not stated in the abstract
AUC
∆ST0.860
CFR0.623
HMR0.653
- ∆ST vs CFR, HMR: P = 0.0002
Further findings
Coronary microvascular dysfunction (CMD) distribution across vessels
- Patients with at least one vessel with abnormal CFR
- All patients
- Vessels with CMD (CFR < 2.5)
- 41
- Structural CMD (HMR > 1.9 mmHg.cm-1.s)
- 26
- Functional CMD (HMR <= 1.9 mmHg.cm-1.s)
- 15
- Patients with CFR < 2.5 in all 3 epicardial arteries
- 7
Original publication
Intracoronary electrocardiogram detects coronary microvascular dysfunction and ischemia in patients with no obstructive coronary arteries disease. Am Heart J. Published 25 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →