Coronary disease & ACSCohort study
Oxygenation-sensitive cardiovascular magnetic resonance imaging to identify coronary microvascular and vasomotor dysfunction in angina and no obstructive coronary artery disease
- prospective, single-centre study
Authors' conclusion
In this small single-centre cohort, we demonstrated the potential of physiologic markers derived from OS-CMR with vasoactive breathing manoeuvres to differentiate ANOCA patients with ICFT confirmed endothelial-dependent CMVD from healthy controls. The clinical utility of this novel approach for non-invasively diagnosing CMVD needs further exploration with external validation in larger studies.
Study context
- Population
- ANOCA patients with endothelium-dependent coronary microvascular and vasomotor dysfunction (CMVD) diagnosed by invasive coronary function test (ICFT), and healthy participantsANOCA patients diagnosed with endothelium-dependent CMVD by ICFT 25 · healthy participants 34
- Participants
- 25 vs 34
- Exposure
- Oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) with vasoactive breathing manoeuvres compared with clinically performed, gold-standard ICFT in ANOCA patients with endothelial-dependent CMVD and healthy controls
- ANOCA-CMVD patientsn = 25
- healthy participantsn = 34
Main finding
As reported in the abstract
Oxygenation response to vasoactive breathing manoeuvres
- Compared to healthy participants, ANOCA-CMVD patients exhibited a significantly impaired oxygenation response to vasoactive breathing manoeuvres
Observational data: associations, not effects.
Further findings
Predictive biomarkers of endothelial-dependent CMVD (LASSO)
- Late-diastolic HV-MOREMI-VAR and peri-systolic BH-MOREMI-AUC emerged as potential predictors of endothelial-dependent CMVD
LASSO-derived multivariate model performance in identifying endothelial-dependent CMVD
- area under the curve
- 0.92
- sensitivity
- 88.9%
- specificity
- 82.1%
- positive predictive value
- 82.8%
- negative predictive value
- 88.5%
- accuracy
- 85.5%
- adjusting for age
- apparent discrimination
Original publication
Oxygenation-sensitive cardiovascular magnetic resonance imaging to identify coronary microvascular and vasomotor dysfunction in angina and no obstructive coronary artery disease. Eur Heart J Cardiovasc Imaging. Published 27 April 2026. doi:10.1093/ehjci/jeag106
Summarised from the published abstract; every number is checked against it