Publication:
Homogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease

Simple item page
dc.contributor.authorHoshino, Masahiro
dc.contributor.authorHoek, Roel
dc.contributor.authorJukema, Ruurt
dc.contributor.authorDahdal, Jorge
dc.contributor.authorVan Diemen, Pepijn
dc.contributor.authorRaijmakers, Pieter
dc.contributor.authorDriessen, Roel
dc.contributor.authorTwisk, Jos
dc.contributor.authorDanad, Ibrahim
dc.contributor.authorKakuta, Tsunekazu
dc.contributor.authorKnuuti, Juhani
dc.contributor.authorKnaapen, Paul
dc.date.accessioned2026-09-23T15:10:31Z
dc.date.available2026-09-23T15:10:31Z
dc.date.issued2025
dc.description.abstractAims: The homogeneity of coronary microvascular dysfunction (CMD) across different myocardial territories in angina with non-obstructive coronary artery disease (ANOCA) patients is scarcely explored. This study investigates the variability in microvascular resistance reserve (MRR) across the 3 main perfusion territories of the coronary circulation to investigate the homogeneity or dishomogeneity of microcirculatory function. Methods and results: This post hoc analysis of the PACIFIC trials included symptomatic ANOCA patients with [15O]H2O positron emission tomography (PET) and three-vessel invasive fractional flow reserve (FFR). MRR was computed in the three main coronary branches by integrating PET-derived coronary flow reserve and invasive FFR. A total of 155 patients (50% male, age 59 ± 10 years) and 465 vessels (MRR: 3.92 ± 1.21) were included. There were no significant differences in MRR among the three coronary branches. Correlations in MRR among the three coronary branches were good (r = 0.76 to 0.86). The mean difference between MRR measurements in different arteries was small (2.4 to 7.5%), without any consistent directional bias. The overall intra-class correlation coefficient for absolute agreement was 0.80 (95% CI: 0.74-0.85), indicating good single-measure reliability. Approximately 80% (123/155) of patients showed diagnostic concordance of CMD (MRR ≤3.0) across the three vessels. Conclusion: In most ANOCA patients, microvascular function is homogeneously distributed across the three major coronary territories. Single-artery testing may suffice in many cases, aligning with guidelines. However, some patients exhibit notable inter-territorial variation, suggesting that multi-vessel evaluation may be prudent in borderline scenarios.
dc.description.versionVersión Publicada
dc.identifier.citationHoshino, M., Hoek, R., Jukema, R. A., Dahdal, J., van Diemen, P., Raijmakers, P., Driessen, R., Twisk, J., Danad, I., Kakuta, T., Knuuti, J., & Knaapen, P. (2025). Homogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease. European heart journal. Cardiovascular Imaging, 26(7), 1120–1127. https://doi.org/10.1093/ehjci/jeaf101
dc.identifier.doihttps://doi.org/10.1093/ehjci/jeaf101
dc.identifier.urihttps://hdl.handle.net/11447/11172
dc.language.isoen
dc.subject[15O]H2O PET
dc.subjectCoronary flow reserve
dc.subjectFractional flow reserve
dc.subjectMicrovascular resistance reserve
dc.subjectnon-obstructive coronary artery disease
dc.titleHomogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceEuropean heart journal. Cardiovascular Imaging
dspace.entity.typePublication

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Homogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease.pdf
Size:
658.3 KB
Format:
Adobe Portable Document Format
Description:
Texto Completo
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
347 B
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services