ReviewHeart (British Cardiac Society)2022
Invasive coronary physiology in patients with angina and non-obstructive coronary artery disease: a consensus document from the coronary microvascular dysfunction workstream of the British Heart Foundation/National Institute for Health Research Partnership.
Review in Heart (British Cardiac Society), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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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.
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Who cites it
48 citing papers in PubMed.
- Acetylcholine Provocation Testing for Coronary Vasomotor Disorders.Reviews in cardiovascular medicine · 2026Review
- A proposal of an echocardiography-based pathway for the diagnosis and management of angina with no obstructive coronary arteries: a state-of-the-art review: Advancing Targeted Therapy and Prognosis Through Endotype Identification.European heart journal. Imaging methods and practice · 2026Review
- Review
- Diagnostic performance of exercise stress testing findings and coronary microvascular dysfunction in patients with angina with non-obstructive coronary artery disease.Heart (British Cardiac Society) · 2026Article
- Evaluation of myocardial microcirculation changes in rats from different altitudes based on CT myocardial perfusion imaging.Biochemistry and biophysics reports · 2026Article
- Article
- Time for contrast to pass through the myocardium and its association with angina severity in patients with non-obstructive coronary artery disease.BMC cardiovascular disorders · 2026Article
- Controlled hyperventilation using a new ventilation navigator software: a feasibility study to provoke hypocapnia and respiratory alkalosis: A proposal for coronary artery vasoreactivity assessment.European heart journal. Imaging methods and practice · 2026Article
- Modern angina assessment: one size does not fit all in the face of angina and non-obstructed coronary arteries.The British journal of cardiology · 2026Article
- Latent profile analysis of health status and influencing factors among patients with coronary heart disease based on patient-reported outcomes.Frontiers in cardiovascular medicine · 2026Article
- Design and rationale for MICROFIT (Microvascular Coronary Rehabilitation For Improving Treatment)-a feasibility randomized trial of intensive lifestyle rehabilitation for symptomatic coronary microvascular dysfunction.Frontiers in cardiovascular medicine · 2026Article
- Diagnostic performance of angiography-derived IMR for coronary microcirculation disease assessment in INOCA patients.Cardiology journal · 2026Article
- Metoprolol vs. Diltiazem in Patients with Angina and Non-Obstructive Coronary Artery Disease with or Without Evidence of Coronary Microvascular Spasm on Acetylcholine Testing.Journal of clinical medicine · 2025Article
- Refractory angina: mechanisms and stratified treatment in obstructive and non-obstructive chronic myocardial ischaemic syndromes.European heart journal · 2025Review
- Additive effect of coronary artery stenosis on left ventricular myocardial strain in patients with essential hypertension: an analysis of cardiac MRI feature tracking.Quantitative imaging in medicine and surgery · 2025Article
- Intermediate coronary microvascular dysfunction: a case report highlighting challenges in diagnosis and management.European heart journal. Case reports · 2025Article
- Multimodality Imaging for Diagnosis of Ischemic Heart Disease in Latin American Women from IAEA (International Atomic Energy Agency) Collaboratory.Current cardiology reports · 2025Review
- Advances in the diagnosis and management of post-percutaneous coronary intervention coronary microvascular dysfunction: Insights into pathophysiology and metabolic risk interactions.World journal of cardiology · 2025Review
- Coronary Microvascular Dysfunction and Vasospastic Angina-Pathophysiology, Diagnosis and Management Strategies.Journal of clinical medicine · 2025Review
- ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes.Journal of cardiovascular development and disease · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Nearly half of all patients with angina have non-obstructive coronary artery disease (ANOCA); this is an umbrella term comprising heterogeneous vascular disorders, each with disparate pathophysiology and prognosis. Approximately two-thirds of patients with ANOCA have coronary microvascular disease (CMD). CMD can be secondary to architectural changes within the microcirculation or secondary to vasomotor dysfunction. An inability of the coronary vasculature to augment blood flow in response to heightened myocardial demand is defined as an impaired coronary flow reserve (CFR), which can be measured non-invasively, using imaging, or invasively during cardiac catheterisation. Impaired CFR is associated with myocardial ischaemia and adverse cardiovascular outcomes.The CMD workstream is part of the cardiovascular partnership between the British Heart Foundation and The National Institute for Health Research in the UK and comprises specialist cardiac centres with expertise in coronary physiology assessment. This document outlines the two main modalities (thermodilution and Doppler techniques) for estimation of coronary flow, vasomotor testing using acetylcholine, and outlines a standard operating procedure that could be considered for adoption by national networks. Accurate and timely disease characterisation of patients with ANOCA will enable clinicians to tailor therapy according to their patients' coronary physiology. This has been shown to improve patients' quality of life and may lead to improved cardiovascular outcomes in the long term.
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