Original Research

DOI: 10.4244/EIJ-D-24-00111

Absolute coronary blood flow across different endotypes of ANOCA

Valeria Paradies1,2, MD, MSc; Pim Mathijs Smits1,3; Matteo Maurina1,4,5, MD; Pietro L. Laforgia6, MD; Marc M.J.M. van der Linden1, MD, PhD; Peter Damman7, MD, PhD; Pieter C. Smits1, MD, PhD

Abstract

BACKGROUND: Intracoronary continuous thermodilution is a novel technique to quantify absolute true coronary flow and microvascular resistance. However, few data are available in patients with angina with non-obstructive coronary arteries (ANOCA).

AIMS: This study aimed to investigate the diagnostic potential of hyperaemic absolute coronary flow (Qmax) and absolute microvascular resistance (Rμ,hyper) among different ANOCA endotypes, and to determine the correlation between continuous – and bolus – thermodilution indexes.

METHODS: A total of 222 patients were scheduled for clinically indicated coronary function testing (CFT), of whom 120 patients were included in this analysis. These patients underwent CFT including acetylcholine (ACh) provocation testing and microvascular function assessment using both bolus and continuous thermodilution.

RESULTS: CFT was negative (CFT−) in 32 (26.7%) patients. Endothelium-dependent dysfunction (ACh+) was present in 63 (52.5%) patients, and coronary microvascular dysfunction (CMD) identified at bolus thermodilution (CMD+) was present in 62 (51.7%) patients. Patients with a positive CFT (CFT+) showed significantly lower Qmax and higher Rμ,hyper values as compared to CFT−. Qmax was significantly lower in CMD+ versus CMD− patients (0.174 vs 0.222 L/min; p=0.04) but...

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Volume 20 Number 19
Oct 7, 2024
Volume 20 Number 19
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