Multivessel Coronary Function Testing Increases Diagnostic Yield in Patients With Angina and Nonobstructive Coronary Arteries

• DOI: 10.1016/j.jcin.2024.03.007
• Publication Date: 2024-05-13T18:54:16Z
• Authors: Rajan Rehan; Christopher C.Y. ...; James Weaver; William Chan; Jennifer A. Tremmel; William F. Fearon; Martin K.C. Ng; Andy S.C. Yong
• Keywords: Coronary arteries; Coronary flow reserve; Vasomotor; Coronary atherosclerosis; Endothelial Dysfunction; Coronary circulation; Fractional Flow Reserve

Invasive CFT is the gold standard for diagnosing coronary vasomotor dysfunction in patients with ANOCA. Most institutions recommend only testing left circulation. Therefore, it unknown whether multiple territories would increase diagnostic yield. The aim of this study was to evaluate yield multivessel, compared single-vessel, invasive function (CFT) angina and nonobstructive arteries (ANOCA). Multivessel systematically performed suspected Vasoreactivity using acetylcholine provocation (20 200 μg) right 80μg) arteries. A pressure-temperature sensor guidewire used physiology assessment all three epicardial vessels. This multicenter included a total 228 vessels from 80 (57.8 ± 11.8 years age, 60% women). Compared single-vessel CFT, multivessel resulted more diagnosed (86.3% vs 68.8%; P = 0.0005), artery spasm (60.0% 47.5%; 0.004), CMD (62.5% 36.3%; < 0.001). Coronary (n 48) predominated system 38), though isolated noted 20.8% 10). microvascular (CMD), defined by abnormal index microcirculatory resistance and/or flow reserve, present 62.5% cohort 50). Among CMD, 27 (33.8%) had 1-vessel 15 (18.8%) 2-vessel 8 (10%) 3-vessel CMD. observed at similar rate supplied 3 major (left anterior descending 36.3%, circumflex 33.8%, 31.3%; 0.486). an increased ANOCA testing. results suggest that has role management