ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2022
Prognostic value of structural and functional coronary microvascular dysfunction in patients with non-obstructive coronary artery disease; from the multicentre international ILIAS registry.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04485234 (Inclusive Invasive Physiological Assessment in Angina Syndromes Registry), which is not on this map. Cited by 58 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Inclusive Invasive Physiological Assessment in Angina Syndromes Registry (ILIAS Registry)
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Pooled it
- Long-term outcomes of ischaemia with no obstructive coronary artery disease (INOCA): a systematic review and meta-analysis.Open heart · 2024Pooled it
- Coronary Microvascular Dysfunction Alters the Pulsatile Behavior of the Resting Coronary Blood Flow.Microcirculation (New York, N.Y. : 1994) · 2025Trial
- Primary versus iatrogenic (post-PCI) coronary microvascular dysfunction: a wire-based multimodal comparison.Open heart · 2023Trial
- Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application.Cardiovascular intervention and therapeutics · 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
- Coronary microvascular function in patients with sepsis and myocardial injury: an invasive coronary physiology study.Critical care (London, England) · 2026Observational
- Coronary microvascular dysfunction: a narrative review.Cardiovascular diagnosis and therapy · 2026Review
- Beyond Stenosis: Mechanism-Based Multimodality Imaging and Invasive Coronary Function Testing for Endotype Definition in ANOCA/INOCA.Medicina (Kaunas, Lithuania) · 2026Review
- A Pathophysiology-Oriented Imaging Phenotype Framework for Nonobstructive Coronary Artery Disease.Journal of cardiovascular development and disease · 2026Article
- Article
- Chronic ischemic heart disease: A nonuniform syndrome.American heart journal plus : cardiology research and practice · 2026Review
- Microvascular Resistance Reserve (MRR): a new concept to understand the coronary microcirculation.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Review
- Prognostic Stratification Based on Left Ventricular Diastolic Dysfunction and Coronary Microvascular Dysfunction in Patients Without Functional Coronary Artery Stenosis.Circulation reports · 2026Article
- Integration of BNP and blood glucose for identifying coronary flow reserve impairment: A cardiovascular-kidney-metabolic perspective.American heart journal plus : cardiology research and practice · 2026Article
- Clinical profile and long-term outcomes of chest pain patients with coronary microvascular dysfunction from the emergency department - results from the Yale-CMD registry.Microvascular research · 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
- Shexiang Tongxin dropping pill for coronary microvascular disease: rationale and design of a multicenter randomized trial with a cardiopulmonary exercise testing primary endpoint and AI-enhanced myocardial contrast echocardiograph.Frontiers in cardiovascular medicine · 2026Article
- Functional coronary vascular disease: endotype-based classification, diagnosis, and targeted management.Frontiers in cardiovascular medicine · 2026Review
- Coronary Sinus Reduction for Refractory Angina Caused by Microvascular Dysfunction-A Systematic Review.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
31 authors at 19 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary microvascular dysfunction (CMD) is an important contributor to angina syndromes. Recently, two distinct endotypes were identified using combined assessment of coronary flow reserve (CFR) and minimal microvascular resistance (MR), termed structural and functional CMD.
aimsWe aimed to assess the relevance of the combined assessment of CFR and MR in patients with angina and no obstructive coronary arteries.
methodsPatients with chronic coronary syndromes (CCS) and non-obstructive coronary artery disease (fractional flow reserve [FFR] ≥0.80) were selected (N=1,102). Functional CMD was defined as abnormal CFR in combination with normal MR and structural CMD as abnormal CFR with abnormal MR. Clinical endpoints were the incidence of major adverse cardiac events (MACE) and target vessel failure (TVF) at 5-year follow-up.
resultsAbnormal CFR was associated with an increased risk of MACE and TVF at 5-year follow-up. Microvascular resistance parameters were not associated with MACE or TVF at 5-year follow-up. The risk of MACE and TVF at 5-year follow-up was similarly increased for patients with structural or functional CMD compared with patients with normal microvascular function. There were no differences between both endotypes (p=0.88 for MACE, and p=0.55 for TVF).
conclusionsCoronary microvascular dysfunction, identified by an impaired CFR, was unequivocally associated with increased MACE and TVF rates over a 5-year follow-up period. In contrast, impaired MR was not associated with 5-year adverse clinical events. Moreover, there was no significant difference in the risk of MACE and TVF between a low CFR accompanied by pathologically increased MR (structural CMD) or not (functional CMD). CLINICALTRIALS: gov: NCT04485234.
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Registered trials
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