| Title: |
Characterization of different phenotypes of microvascular dysfunction and their impact on angina severity in patients with chronic angina without apparent obstructive coronary artery disease |
| Authors: |
Di Serafino, L; Polimeni, A; Campo, G; Scarsini, R; Biancofiore, A; Leone, A M; D'ascenzo, F; Ielasi, A; Niccoli, G; Porto, I; Fineschi, M; Belloni, F; Canova, P A; Indolfi, C; Esposito, G |
| Source: |
European Heart Journal Supplements ; volume 28, issue Supplement_3 ; ISSN 1520-765X 1554-2815 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2026 |
| Description: |
Background Around half of the patients undergoing coronary angiography for angina and/or myocardial ischemia are found to have non-obstructive coronary artery disease (CAD). Coronary microvascular dysfunction (CMD) is increasingly recognized as a key contributor to angina and ischemic symptoms in this population. Objective This study aims to evaluate coronary physiology and microvascular function in patients with angina and ischemia who do not present with obstructive CAD. Methods The MiVa registry is a prospective, multicenter study in Italy enrolling patients with angina and ischemia detected by non-invasive testing, who were referred for coronary angiography and found to have non-obstructive CAD. All patients underwent an invasive assessment of coronary physiology, including measurements of coronary flow reserve (CFR), index of myocardial resistance (IMR) and fractional flow reserve (FFR). Acetylcholine provocation testing was strongly recommended. Results Between September 2022 and November 2024, 400 patients were enrolled (46% female; mean age 64 ± 10 years) in 16 Italian institutions. The most prevalent cardiovascular risk factors were dyslipidemia (78%), hypertension (75%), family history of CAD (31%), and obesity (25%). The mean values of coronary physiological indices were CFR (2.9 ± 1.1), IMR (24 ± 19), and FFR (0.88 ± 0.08). CMD was diagnosed in 47% of patients. Based on pathophysiological classification, 37% had structural CMD (CFR 25), 28% had initial structural CMD (CFR >2.5, IMR >25), and 35% had functional CMD (CFR |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/eurheartjsupp/suag056.035 |
| Availability: |
https://doi.org/10.1093/eurheartjsupp/suag056.035; https://academic.oup.com/eurheartjsupp/article-pdf/28/Supplement_3/suag056.035/67654242/suag056.035.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.3BC3CB5E |
| Database: |
BASE |