Multicenter Prospective Assessment of Coronary Microvascular Dysfunction: Primary Results of the FlowLab Study
Authors' conclusion
In a prospective assessment of invasive testing for CMD/VSA, we observed varied procedural and technical approaches. Testing was rapid, and a final diagnosis of CMD or VSA was common with immediate implications for patient management.
Study context
- Population
- Patients with possible coronary microvascular dysfunction undergoing invasive coronary microvascular dysfunction (CMD)/vasospastic angina (VSA) assessment with CoroFlow bolus thermodilution
- Participants
- 253 procedures
- Outcome
- Procedural and diagnostic findings of invasive CMD/VSA assessment (single group)
Methodological detailsmulticentre, 14 US sites
- Multicentre
- 14 US sites
Main finding
As reported in the abstract
- CoroFlow duration, median (IQR 7-14)
- 10 minutes
- Provocative vasospasm testing performed
- 50% (124/246)
- Abnormal coronary flow reserve (<2.5)
- 43% (110/253)
- Abnormal index of microcirculatory resistance (IMR) (≥25)
- 28% (72/253)
- CMD/VSA identified
- 53% (135/253)
- Final diagnosis CMD
- 59% (19/32)
- Final diagnosis VSA
- 28% (9/32)
Observational data: associations, not effects.
Further findings
Anginal therapy addition, elevated vs non-elevated IMR
P < 0.0001
Presenting symptoms
- Chest pain (222/253)
- 88%
- Dyspnea (93/253)
- 37%
Original publication
Multicenter Prospective Assessment of Coronary Microvascular Dysfunction: Primary Results of the FlowLab Study. JACC Adv. Published 26 September 2025. doi:10.
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