Evidence map›Paper›PMID 41860489›Full record

ArticleJACC. Case reports2026

Invasive Confirmation of Microvascular Recovery Parallel to Left Ventricular Functional Restoration.

Takumi Toya, Takumi Kondo, Otoya Sekine, Masayuki Aoyama, Nayuka Sumida, Takafumi Nishimura, Yoshichika Miyazaki, Kohei Inagawa, Munehisa Sakamoto, Yukihiko Momiyama

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Takumi ToyaDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan; Nishikoyama Toya Medical Clinic-Diabetes and Cardiovascular Care, Tokyo, Japan. Electronic address: tyt0725@gmail.com.
Takumi KondoDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Otoya SekineDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Masayuki AoyamaDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Nayuka SumidaDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Takafumi NishimuraDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Yoshichika MiyazakiDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Kohei InagawaDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Munehisa SakamotoDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.
Yukihiko MomiyamaDepartment of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronary microvascular dysfunction (CMD) is increasingly implicated in heart failure, but reversal with guideline-directed medical therapy (GDMT) is rarely documented using invasive physiology. CASE SUMMARY: A 53-year-old man presented with paroxysmal nocturnal dyspnea. Electrocardiography showed precordial ST-T changes; brain natriuretic peptide was 419 pg/mL; left ventricular ejection fraction 35% with anteroseptal hypokinesis. Coronary angiography revealed intermediate proximal left anterior descending artery disease with nonischemic fractional flow reserve (0.84). Invasive indices indicated CMD (mean transit time [Tmn] 2.41/0.70 s; coronary flow reserve [CFR] 3.4; index of microvascular resistance [IMR] 59). After GDMT, left ventricular ejection fraction normalized (63%), and brain natriuretic peptide fell to 4.0 pg/mL at 3 months. Repeat physiology showed restored microvascular function (Tmn 0.84/0.20 s; CFR 4.2; IMR 15); fractional flow reserve remained nonischemic (0.82). DISCUSSION: Marked improvement in IMR/CFR supports CMD-rather than epicardial stenosis-as the principal driver of the initial ischemic phenotype. GDMT may enhance microvascular vasodilator tone and myocardial energetics, improving CMD. TAKE-HOME MESSAGE: Contemporary GDMT may favorably modulate the coronary microcirculation; improvement in CMD may parallel clinical recovery.

Indexed as

coronary microvascular dysfunctionheart failureischemic cardiomyopathy

Identifiers

PMID41860489
PMCPMC13112556

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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.