ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023
Prognostic value of combined coronary angiography-derived IMR and myocardial perfusion imaging by CZT SPECT in INOCA.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Diagnostic and prognostic value of angiography-derived index of microvascular resistance: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Prognostic value of myocardial perfusion imaging by cadmium zinc telluride single-photon emission computed tomography in patients with suspected or known coronary artery disease: a systematic review and meta-analysis.European journal of nuclear medicine and molecular imaging · 2023Pooled it
- The value of myocardial perfusion CZT-SPECT in the assessment of coronary microvascular dysfunction in INOCA patients: a comparative study with caIMR.The international journal of cardiovascular imaging · 2026Article
- Review
- The prognostic value of multiparameters derived from D-SPECT in patients with ANOCA.Annals of nuclear medicine · 2026Article
- Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025Article
- From Intracoronary Physiology to Endotype-Based Treatment: Quality of Life Improvement for INOCA Patients.Journal of clinical medicine · 2025Article
- Coronary Microvascular Dysfunction: Insights on Prognosis and Future Perspectives.Reviews in cardiovascular medicine · 2025Review
- Coronary angiography-derived index of microcirculatory resistance associated with contrast-induced acute kidney injury in patients with STEMI.Frontiers in cardiovascular medicine · 2025Article
- Effect of nonobstructive coronary stenosis on coronary microvascular dysfunction and long-term outcomes in patients with INOCA.Clinical cardiology · 2023Article
- Epicardial fat volume, an independent risk factor for major adverse cardiovascular events, had an incremental prognostic value to myocardial perfusion imaging in Chinese populations with suspected or known coronary artery disease with a normal left ventricular ejection fraction.Frontiers in cardiovascular medicine · 2023Article
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA significant proportion of ischemia with non-obstructive coronary artery disease (INOCA) demonstrate coronary microvascular dysfunction (CMD), a condition associated with abnormal myocardial perfusion imaging (MPI) and adverse outcomes. Coronary angiography-derived index of microvascular resistance (caIMR) is a novel non-invasive technique to assess CMD. We aimed to investigate the prognostic value of combined caIMR and MPI by CZT SPECT in INOCA patients.
methodsConsecutive 151 patients with chest pain and < 50% coronary stenosis who underwent coronary angiography and MPI within 3 months were enrolled. caIMR was calculated by computational pressure-flow dynamics. CMD was defined as caIMR ≥ 25. The endpoint was major adverse cardiac events (MACE: cardiovascular death, nonfatal myocardial infarction, revascularization, angina-related rehospitalization, heart failure, and stroke).
resultsOf all INOCA patients, CMD was present in 93 (61.6%) patients. The prevalence of abnormal MPI was significantly higher in CMD compared with non-CMD patients (40.9% vs 13.8%, P < .001). CMD showed a higher risk of MACE than non-CMD patients. Patients with both CMD and abnormal MPI had the worst prognosis, followed by patients with CMD and normal MPI (log-rank P < .001). Cox regression analysis identified CMD (HR 3.121, 95%CI 1.221-7.974, P = .017) and MPI (HR 2.704, 95%CI 1.030-7.099, P = .043) as predictive of MACE. The prognostic value of INOCA patients enhanced significantly by adding CMD and MPI to the model with clinical risk factors (AUC = 0.777 vs 0.686, P = .030).
conclusioncaIMR-derived CMD is associated with increased risk of MACE among INOCA patients. Patients with abnormalities on both caIMR and MPI had the worse outcomes.
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