ArticleJournal of the American College of Cardiology2018
Diagnosis of Microvascular Angina Using Cardiac Magnetic Resonance.
Article in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 117 citations in OpenAlex.
- Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.BMC medical imaging · 2021Pooled it
- Efficacy and safety of intensive antihypertensive strategy in patients with low diastolic blood pressure: a secondary analysis of a cluster randomised trial.Heart (British Cardiac Society) · 2026Trial
- Trial
- Coronary Microvascular Dysfunction Is Associated With Myocardial Ischemia and Abnormal Coronary Perfusion During Exercise.Circulation · 2019Trial
- Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Quantitative perfusion by cardiac magnetic resonance imaging reveals compromised myocardial perfusion in patients with angina with non-obstructive coronary artery disease.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study.Cardiovascular diabetology · 2024Article
- Pathogenesis, Assessment, and Treatment of Coronary Microcirculation Dysfunction.Arquivos brasileiros de cardiologia · 2024Review
- Tissue-growth-based synthetic tree generation and perfusion simulation.Biomechanics and modeling in mechanobiology · 2023Article
- The Non-Invasive Diagnosis of Chronic Coronary Syndrome: A Focus on Stress Computed Tomography Perfusion and Stress Cardiac Magnetic Resonance.Journal of clinical medicine · 2023Review
- Personalized Management for Heart Failure with Preserved Ejection Fraction.Journal of personalized medicine · 2023Review
- Article
- Imaging techniques for the assessment of adverse cardiac remodeling in metabolic syndrome.Heart failure reviews · 2022Review
- Coronary functional assessment in non-obstructive coronary artery disease: Present situation and future direction.Frontiers in cardiovascular medicine · 2022Review
- Assessment and Treatment for Coronary Microvascular Dysfunction by Contrast Enhanced Ultrasound.Frontiers in cardiovascular medicine · 2022Review
- Can myocardial perfusion imaging predict outcome in patients with angina and ischemia but no obstructive coronary artery disease (INOCA)?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Vascularisation of pluripotent stem cell-derived myocardium: biomechanical insights for physiological relevance in cardiac tissue engineering.Pflugers Archiv : European journal of physiology · 2021Review
- Sweat the small stuff: The human microvasculature and heart disease.Microcirculation (New York, N.Y. : 1994) · 2021Review
- Coronary microvascular disease: current concepts of pathophysiology, diagnosis and management.Cardiovascular endocrinology & metabolism · 2021Review
- Microvascular Dysfunction in Diabetes Mellitus and Cardiometabolic Disease.Endocrine reviews · 2021Review
Corrections and comments
- Retraction · 2020-10-12Complaints about Company/Institution · Concerns/Issues about Data · Falsification/Fabrication of Image · Investigation by Company/Institution · Misconduct - Official Investigation(s) and/or Finding(s) · Misconduct by Author · Objections by Author(s) ·
- Commented on by
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- Retracted
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIn patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD).
objectivesThe goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography.
methodsFifty patients with angina (65 ± 9 years of age) and 20 age-matched healthy control subjects underwent adenosine stress CMR (1.5- and 3-T) to assess left ventricular function, inducible ischemia (myocardial perfusion reserve index [MPRI]; myocardial blood flow [MBF]), and infarction (late gadolinium enhancement). During subsequent angiography within 7 days, 28 patients had obstructive CAD (fractional flow reserve [FFR] ≤0.8) and 22 patients had NOCAD (FFR >0.8) who underwent 3-vessel IMR measurements.
resultsIn patients with NOCAD, myocardium with IMR <25 U had normal MPRI (1.9 ± 0.4 vs. controls 2.0 ± 0.3; p = 0.49); myocardium with IMR ≥25 U had significantly impaired MPRI, similar to ischemic myocardium downstream of obstructive CAD (1.2 ± 0.3 vs. 1.2 ± 0.4; p = 0.61). An MPRI of 1.4 accurately detected impaired perfusion related to CMD (IMR ≥25 U; FFR >0.8) (area under the curve: 0.90; specificity: 95%; sensitivity: 89%; p < 0.001). Impaired MPRI in patients with NOCAD was driven by impaired augmentation of MBF during stress, with normal resting MBF. Myocardium with FFR >0.8 and normal IMR (<25 U) still had blunted stress MBF, suggesting mild CMD, which was distinguishable from control subjects by using a stress MBF threshold of 2.3 ml/min/g with 100% positive predictive value.
conclusionsIn angina patients with NOCAD, CMR can objectively and noninvasively assess microvascular angina. A CMR-based combined diagnostic pathway for both epicardial and microvascular CAD deserves further clinical validation.
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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.