Evidence map›Paper›PMID 28374328›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2018

Epicardial and microvascular coronary vasomotor dysfunction and its relation to myocardial ischemic burden in patients with non-obstructive coronary artery disease.

Edoardo Verna, Sergio Ghiringhelli, Stefano Provasoli, Simone Scotti, Jorge Salerno-Uriarte

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Ischaemia with no obstructive coronary arteries.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020
    Review
  7. Myocardial ischemia without obstructive CAD: there is more than meets the eye!Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Edoardo VernaDepartment of Cardiology, Ospedale di Circolo & Fondazione Macchi, University Hospital-Varese, Università dell'Insubria, Viale Borri 57, 21100, Varese, Italy. edoardo.verna@virgilio.it.
Sergio GhiringhelliDepartment of Cardiology, Ospedale di Circolo & Fondazione Macchi, University Hospital-Varese, Università dell'Insubria, Viale Borri 57, 21100, Varese, Italy.
Stefano ProvasoliDepartment of Cardiology, Ospedale di Circolo & Fondazione Macchi, University Hospital-Varese, Università dell'Insubria, Viale Borri 57, 21100, Varese, Italy.
Simone ScottiNuclear Medicine, Ospedale di Circolo & Fondazione Macchi, University Hospital, Università dell'Insubria, Varese, Italy.
Jorge Salerno-UriarteDepartment of Cardiology, Ospedale di Circolo & Fondazione Macchi, University Hospital-Varese, Università dell'Insubria, Viale Borri 57, 21100, Varese, Italy.
Ospedale di Circolo e Fondazione Macchi · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo assess the relative contribution of epicardial endothelium-dependent (EDD) and microvascular endothelium-independent (EIMVD) coronary vasomotor dysfunction to the extent of myocardial ischemia in patients with normal angiograms or non-obstructive coronary artery disease (NOCAD).

methodsCoronary vasomotion was evaluated by quantitative angiography and blood flow (CBF) measurements during intracoronary acetylcholine, nitroglycerine, and adenosine in 101 patients. Myocardial SPECT ischemic burden was evaluated by semi-quantitative scoring of summed stress (SSS) and summed ischemic (SDS) perfusion defect size.

resultsCoronary vasomotor dysfunction was found in most patients (83; 77%) with a divergent behavior of EDD and EIMVD in one half of them (52.4%). There was no significant difference in SDS between patients with and without EIMVD, whereas SDS was significantly greater in subjects with EDD as compared to patients with normal response to acetylcholine (4.31 ± 2.44 vs 1.35 ± 1.45; P < .0001). Patients with EDD, either alone or in combination with EIMVD, had significantly higher SSS as compared to patients with lone EIMVD or normal vasomotor function (8.50 ± 5.32; 5.55 ± 3.21; 2.60 ± 2.14; and 1.74 ± 1.66, respectively; P < .0001). Acetylcholine CBF correlated inversely with both SDS (r = -0.545; P < .001) and SSS (r = 0.538; P < .001).

conclusionsIn NOCAD patients with symptoms and signs of myocardial ischemia, vasomotor dysfunction is common. EDD is associated with greater extent of ischemia as compared to isolated EIMVD. Thus, assessment of both EIMVD and EDD is needed to recognize mechanisms of ischemia and identify patients with greater ischemic burden.

Indexed as

AdultAgedCoronary Artery DiseaseCoronary CirculationCoronary VesselsEndothelium, VascularFemaleHumansMaleMicrovesselsMiddle AgedMyocardial IschemiaPericardiumCoronary artery diseaseCoronary blood flowEndothelial dysfunctionMicrovascular diseaseMyocardial perfusion imaging (SPECT)

Identifiers

PMID28374328
OpenAlexW2604973621

What OpenQuestion holds

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Registered trials

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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.