ArticleClinical research in cardiology : official journal of the German Cardiac Society2019
Coronary microvascular dysfunction in patients with acute coronary syndrome and no obstructive coronary artery disease.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Prevalence of Coronary Microvascular Disease and Coronary Vasospasm in Patients With Nonobstructive Coronary Artery Disease: Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2022Pooled it
- Myocardial Infarction With Non-Obstructive Coronary Artery Disease: Exploration of the Etiology to Guide Therapy.Reviews in cardiovascular medicine · 2026Review
- Non-invasive Coronary Functional Tests in Patients with Angina and Non-obstructive Coronary Artery Disease.European cardiology · 2026Article
- Correlation between calcium levels and coronary microvascular disease in high-altitude environments: nested case-control study.Frontiers in cardiovascular medicine · 2026Article
- Angina Pectoris Prevalence and Sick Leave Burden 1 Year After Myocardial Infarction With Nonobstructive Coronary Arteries.Journal of the American Heart Association · 2025Article
- Endothelial Cell-Specific Prolyl Hydroxylase-2 Deficiency Augments Angiotensin II-Induced Arterial Stiffness and Cardiac Pericyte Recruitment in Mice.Journal of the American Heart Association · 2024Article
- Navigating the Landscape of Coronary Microvascular Research: Trends, Triumphs, and Challenges Ahead.Reviews in cardiovascular medicine · 2024Review
- Review
- Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease.Frontiers in cardiovascular medicine · 2024Article
- Inflammation and coronary microvascular disease: relationship, mechanism and treatment.Frontiers in cardiovascular medicine · 2024Review
- Reduced stress perfusion in myocardial infarction with nonobstructive coronary arteries.Scientific reports · 2023Article
- Global trends and frontiers in research on coronary microvascular dysfunction: a bibliometric analysis from 2002 to 2022.European journal of medical research · 2022Review
- Prevalence and characteristics of coronary microvascular dysfunction in post-percutaneous coronary intervention patients with recurrent chest pain.Cardiovascular diagnosis and therapy · 2022Article
- Antiplatelet therapy in patients with myocardial infarction with non-obstructive coronary arteries: A clinical perspective.Frontiers in cardiovascular medicine · 2022Article
- Review
- The Pivotal Role of Invasive Functional Assessment in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries (MINOCA).Frontiers in cardiovascular medicine · 2021Review
- Apnea Hypopnea Index is an Independent Predictor of Coronary Microcirculatory Dysfunction in Stable Angina Pectoris Patients with a Single Borderline Lesion.Acta Cardiologica Sinica · 2020Article
- Clinical, angiographic and echocardiographic correlates of epicardial and microvascular spasm in patients with myocardial ischaemia and non-obstructive coronary arteries.Clinical research in cardiology : official journal of the German Cardiac Society · 2020 · on this mapArticle
- ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on 'coronary microvascular dysfunction in cardiovascular disease'.Cardiovascular research · 2020Review
- Nucleotide ecto-enzyme metabolic pattern and spatial distribution in calcific aortic valve disease; its relation to pathological changes and clinical presentation.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBetween 10 and 15% of patients admitted for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) show no obstructive coronary artery disease (NO-CAD) at angiography. Coronary microvascular spasm is a possible mechanism of the syndrome, but there are scarce data about coronary microvascular function in these patients.
objectivesTo assess coronary microvascular function in patients with NSTE-ACS and NO-CAD.
methodsWe studied 30 patients (67 ± 10 years, 19 female) with NSTE-ACS and NO-CAD. Specific causes of NSTE-ACS presentation (e.g., variant angina, takotsubo disease, tachyarrhythmias, etc.) were excluded. Coronary blood flow (CBF) velocity response to IV ergonovine (6 µg/kg up to a maximal dose of 400 µg) was evaluated before discharge by transthoracic Doppler echocardiography. CBF response to IV adenosine (140 μg/kg/min) and cold pressor test (CPT) was also assessed after 1 month. Ten age- and sex-matched patients with non-cardiac chest pain served as controls. Vasoactive tests were repeated after 12 months in 10 NSTE-ACS patients.
resultsThe ergonovine/basal CBF velocity ratio was 0.79 ± 0.09 and 0.99 ± 0.01 in patients and controls, respectively (p < 0.001). The adenosine/basal CBF velocity ratio was 1.46 ± 0.2 and 3.25 ± 1.2 in patients and controls, respectively (p < 0.001), and the CPT/basal CBF velocity ratio was 1.36 ± 0.2 and 2.43 ± 0.3 in the 2 groups, respectively (p < 0.001). In 10 patients assessed after 12 months, CBF velocity responses to ergonovine, adenosine, and CPT were found to be unchanged.
conclusionsPatients with NSTE-ACS and NO-CAD exhibit a significant coronary dysfunction, which seems to involve both an increased constrictor reactivity, likely mainly involving coronary microcirculation, and a reduced microvascular dilator function, both persisting at 12-month follow-up.
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