ArticleJACC. Cardiovascular interventions2024
Angiographic Coronary Slow Flow Is Not a Valid Surrogate for Invasively Diagnosed Coronary Microvascular Dysfunction.
Article in JACC. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 24 citations in OpenAlex.
- Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application.Cardiovascular intervention and therapeutics · 2026Review
- Association Between Pittsburgh Sleep Quality Index Scores and TIMI Frame Count-Defined Coronary Slow Flow Phenomenon in Patients with Nonobstructive Coronary Arteries: A Cross-Sectional Study.Journal of cardiovascular development and disease · 2026Article
- Simple risk stratification for a complex coronary phenotype: association of the ACEF score with coronary slow flow.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026Article
- 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
- Article
- Angiography-Derived Versus Coronary Guidewire-Derived Index of Microcirculatory Resistance in Patients With Ischemia With Nonobstructive Coronary Arteries.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Coronary Slow-Flow Syndrome: A Review on Natural History of Disease and Best Practices.Research in heart yield and translational medicine · 2025Review
- Article
- Epicardial fat volume is associated with primary coronary slow-flow phenomenon in patients with severe aortic stenosis undergoing transcatheter valve implantation.BMC cardiovascular disorders · 2024Article
- Coronary angiography: a review of the state of the art and the evolution of angiography in cardio therapeutics.Frontiers in cardiovascular medicine · 2024Review
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundIschemia with no obstructive coronary arteries is frequently caused by coronary microvascular dysfunction (CMD). Consensus diagnostic criteria for CMD include baseline angiographic slow flow by corrected TIMI (Thrombolysis In Myocardial Infarction) frame count (cTFC), but correlations between slow flow and CMD measured by invasive coronary function testing (CFT) are uncertain.
objectivesThe aim of this study was to investigate relationships between cTFC and invasive CFT for CMD.
methodsAdults with ischemia with no obstructive coronary arteries underwent invasive CFT with thermodilution-derived baseline coronary blood flow, coronary flow reserve (CFR), and index of microcirculatory resistance (IMR). CMD was defined as abnormal CFR (<2.5) and/or abnormal IMR (≥25). cTFC was measured from baseline angiography; slow flow was defined as cTFC >25. Correlations between cTFC and baseline coronary flow and between CFR and IMR and associations between slow flow and invasive measures of CMD were evaluated, adjusted for covariates. All patients provided consent.
resultsAmong 508 adults, 49% had coronary slow flow. Patients with slow flow were more likely to have abnormal IMR (36% vs 26%; P = 0.019) but less likely to have abnormal CFR (28% vs 42%; P = 0.001), with no difference in CMD (46% vs 51%). cTFC was weakly correlated with baseline coronary blood flow (r = -0.35; 95% CI: -0.42 to -0.27), CFR (r = 0.20; 95% CI: 0.12 to 0.28), and IMR (r = 0.16; 95% CI: 0.07-0.24). In multivariable models, slow flow was associated with lower odds of abnormal CFR (adjusted OR: 0.53; 95% CI: 0.35 to 0.80).
conclusionsCoronary slow flow was weakly associated with results of invasive CFT and should not be used as a surrogate for the invasive diagnosis of CMD.
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