Evidence map›Paper›PMID 11705815›Full record

ArticleCirculation2001

Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but "Normal" coronary angiography.

B De Bruyne, F Hersbach, N H Pijls, J Bartunek, J W Bech, G R Heyndrickx, K L Gould, W Wijns

Registry-linked trialAbstract read
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In one paragraph

Article in Circulation, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05392959 (Effect of the Antidiabetic Drug DAPAgliflozin on the Coronary Macrovascular and MICROvascular Function in Type 2 Diabetic Patients), which is not on this map. Cited by 151 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
151citing papers in PubMed, 6 pooled it
11.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05392959 phase4terminatedstarted 2022, after this paper: background citation

Effect of the Antidiabetic Drug DAPAgliflozin on the Coronary Macrovascular and MICROvascular Function in Type 2 Diabetic Patients

Ran2022Enrolled4Registered outcomes3Posted comparisons0ConditionsDiabetes Mellitus, Type 2ArmsDapagliflozin 10 mg Tab, Placebo
PMID 20609968PMID 25538310PMID 25488697PMID 28254770PMID 7586302PMID 22340827PMID 21126613PMID 20566676PMID 19144937PMID 15466646PMID 14972422PMID 12821539other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

151 citing papers in PubMed, 6 syntheses or guidelines pooled it, 489 citations in OpenAlex.

  1. Diagnostic accuracy of optical flow ratio: an individual patient-data meta-analysis.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023
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  7. Utility ofCirculation. Cardiovascular imaging · 2025
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91 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

B De BruyneCardiovascular Center Aalst, Aalst, Belgium. bernard.de.bruyne@olvz-aalst.be
F Hersbach
N H Pijls
J Bartunek
J W Bech
G R Heyndrickx
K L Gould
W Wijns
Catharina Ziekenhuis · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronary arteries without focal stenosis at angiography are generally considered non-flow-limiting. However, atherosclerosis is a diffuse process that often remains invisible at angiography. Accordingly, we hypothesized that in patients with coronary artery disease, nonstenotic coronary arteries induce a decrease in pressure along their length due to diffuse coronary atherosclerosis. METHODS AND

resultsCoronary pressure and fractional flow reserve (FFR), as indices of coronary conductance, were obtained from 37 arteries in 10 individuals without atherosclerosis (group I) and from 106 nonstenotic arteries in 62 patients with arteriographic stenoses in another coronary artery (group II). In group I, the pressure gradient between aorta and distal coronary artery was minimal at rest (1+/-1 mm Hg) and during maximal hyperemia (3+/-3 mm Hg). Corresponding values were significantly larger in group II (5+/-4 mm Hg and 10+/-8 mm Hg, respectively; both P<0.001). The FFR was near unity (0.97+/-0.02; range, 0.92 to 1) in group I, indicating no resistance to flow in truly normal coronary arteries, but it was significantly lower (0.89+/-0.08; range, 0.69 to 1) in group II, indicating a higher resistance to flow. In 57% of arteries in group II, FFR was lower than the lowest value in group I. In 8% of arteries in group II, FFR was <0.75, the threshold for inducible ischemia.

conclusionDiffuse coronary atherosclerosis without focal stenosis at angiography causes a graded, continuous pressure fall along arterial length. This resistance to flow contributes to myocardial ischemia and has consequences for decision-making during percutaneous coronary interventions.

Indexed as

Coronary AngiographyVascular ResistanceBlood Flow VelocityCoronary Artery DiseaseCoronary CirculationCoronary StenosisFemaleHumansMaleMiddle AgedMyocardial IschemiaPericardiumStents

Identifiers

PMID11705815
OpenAlexW2150672502

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.