Evidence map›Paper›PMID 39206616›Full record

SynthesisAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2024

The Diagnostic Value of ECG Characteristics for Vasospastic and Microvascular Angina: A Systematic Review.

Diantha J M Schipaanboord, Janneke Woudstra, Yolande Appelman, Saskia Z H Rittersma, Tim P van de Hoef, René van Es, Ruben Coronel, Peter Damman, Pim van der Harst, N Charlotte Onland-Moret and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Holter features to detect coronary artery spasm in ANOCA patients: A pilot study.International journal of cardiology. Heart & vasculature · 2026
    Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Diantha J M SchipaanboordLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0003-4205-1255
Janneke WoudstraDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, Amsterdam, The Netherlands.
Yolande AppelmanDepartment of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, Amsterdam, The Netherlands.
Saskia Z H RittersmaDepartment of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Tim P van de HoefDepartment of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
René van EsDepartment of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Ruben CoronelDepartment of Experimental Cardiology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Peter DammanDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Pim van der HarstDepartment of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
N Charlotte Onland-MoretJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Hester M den RuijterLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Funding

Dutch Cardiovascular Alliance Consortium IMPRESS 2020B004
6 · The paper itself

Abstract

backgroundCoronary vascular dysfunction comprises VSA and/or MVA and is more common in women than in men with angina without obstructive coronary artery disease (ANOCA). Invasive coronary function testing is considered the reference test for diagnosis, but its burden on patients is large. We aimed to investigate the potential of electrocardiography (ECG) as noninvasive marker for vasospastic angina (VSA) and microvascular angina (MVA) diagnosis.

methodsWe systematically screened Pubmed and EMBASE databases for studies reporting on ECG characteristics in ANOCA patients with (a suspicion of) coronary vascular dysfunction. We assessed study quality using QUADAS-2. We extracted data on diagnostic values of different ECG characteristics and analyzed whether the studies were sex-stratified.

resultsThirty publications met our criteria, 13 reported on VSA and 17 on MVA. The majority addressed repolarization-related ECG parameters. Only 1 of the 13 VSA papers and 4 of the 17 MVA papers showed diagnostic accuracy measures of the ECG characteristics. The presence of early repolarization, T-wave alternans, and inverted U waves showed of predictive value for VSA diagnosis. The QTc interval was predictive for MVA diagnosis in all six studies reporting on QTc interval. Sex-stratified results were reported in only 5 of the 30 studies and 3 of those observed sex-based differences.

conclusionsECG features are not widely evaluated in diagnostic studies for VSA and MVA. Those features predictive for VSA and MVA diagnosis mostly point to repolarization abnormalities and may contribute to noninvasive risk stratification.

Indexed as

Coronary VasospasmElectrocardiographyMicrovascular AnginaFemaleHumansMaleANOCAcoronary microvascular dysfunctioncoronary vasospasmdiagnosiselectrocardiographysex

Identifiers

PMID39206616
PMCPMC11358703

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.