Abstract
Background: In the clinical setting; the microvascular vasodilatory function test (MVFT) with a pressure wire has been used in ischaemia patients with non-obstructive coronary arteries (INOCA), including vasospastic angina (VSA) and microvascular angina (MVA). The exact factors that affect the microvascular vasodilatory function (MVF) in such patients are still unknown. We aimed to identify the factors, including clinical parameters and lesion characteristics, affecting the MVF in such patients. Methods: A total of 53 patients who underwent coronary angiography, spasm provocation tests (SPTs) and MVFTs were enrolled. In the MVFT, the coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were measured. Of the 53 patients, MVFT data in the left anterior descending coronary artery (LAD) were obtained from 49 patients, and the clinical parameters were checked in all of them. Based on the results of the SPT, coronary spasms were divided into focal spasm, diffuse spasm, and microvascular spasm (MVS). To assess the lesion characteristics influencing MVF, MVFT data were compared according to the types of coronary spasm and coronary vessels in 73 vessels of the 53 patients. Results: In 49 patients who underwent the MVFT in the LAD, the IMR was higher in active smokers (n = 7) than in former smokers (n = 15) and never smokers (n = 27, p < 0.01). In the 73 coronary arteries in this study, the type of coronary spasm did not correlate with the CFR or IMR, whereas a higher IMR were more frequently observed in cases of focal spasm than in cases of diffuse spasm (p = 0.03). In addition, the IMR was higher in the right coronary artery (RCA) than in the LAD (p = 0.02). Conclusion: These results indicate that the smoking status affected the MVF in patients with INOCA, suggesting the possibility of improvement in the MVF by smoking cessation in such patients. In addition, in the assessment of MVF, it may be important to take into account which coronary artery or types of coronary spasm are being evaluated.
Highlights
Introduction published maps and institutional affilThe assessment and treatment of epicardial coronary stenosis are well established [1].in the clinical setting, many patients develop ischaemia with non-obstructive coronary arteries (INOCA) [2]
This study aimed to investigate the relationship between the microvascular vasodilatory function (MVF) and clinical parameters and whether the function varies according to the lesion characteristics of the coronary artery, including the types of coronary spasm
Subsequent analyses of the relationship between the clinical parameters and index of microcirculatory resistance (IMR) were conducted on 49 patients in whom microvascular vasodilatory function test (MVFT) data could be obtained in the left anterior descending coronary artery (LAD) (Analysis 1)
Summary
In the clinical setting, many patients develop ischaemia with non-obstructive coronary arteries (INOCA) [2]. INOCA has several endotypes, such as vasospastic angina (VSA), microvascular spasm (MVS), microvascular vasodilatory dysfunction (MVD) and a combination of VSA and MVD [3,4,5]. In the clinical setting; the microvascular vasodilatory function test (MVFT). With a pressure wire has been used in ischaemia patients with non-obstructive coronary arteries (INOCA), including vasospastic angina (VSA) and microvascular angina (MVA). The exact factors that affect the microvascular vasodilatory function (MVF) in such patients are still unknown. We aimed to identify the factors, including clinical parameters and lesion characteristics, affecting the MVF in such patients. Methods: A total of 53 patients who underwent coronary angiography, spasm provocation tests (SPTs) and MVFTs were enrolled.
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