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Initial Single-Center Experience of a Standardized Protocol for Invasive Assessment of Ischemia and Non-Obstructive Coronary Artery Disease

2023-05Journal article Open access
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dc.contributor.authorVaz Ferreira, V
dc.contributor.authorRamos, R
dc.contributor.authorCastelo, A
dc.contributor.authorMendonça, T
dc.contributor.authorAlmeida-Morais, L
dc.contributor.authorPereira-da-Silva, T
dc.contributor.authorOliveira, E
dc.contributor.authorViegas, J
dc.contributor.authorGarcia Brás, P
dc.contributor.authorGrazina, A
dc.contributor.authorCacela, D
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2023-08-02T15:08:15Z
dc.date.available2023-08-02T15:08:15Z
dc.date.issued2023-05
dc.description.abstractIntroduction: Coronary vasomotion disorders (CVDs), including microvascular angina (MVA) and vasospastic angina (VSA), account for significant morbidity among patients with non-obstructive coronary artery disease (NOCAD). However, protocols for CVD assessment in clinical practice are seldom standardized and may be difficult to implement. Purpose: To assess the safety and feasibility of a comprehensive coronary function test (CFT) protocol for assessment of CVD and the prevalence of different phenotypes of CVD in patients with angina and NOCAD (ANOCA). Methods: Patients with persistent angina referred for invasive coronary angiogram and found to have NOCAD were prospectively recruited and underwent a CFT. Functional parameters (fractional flow reserve, coronary flow reserve and index of myocardial resistance) and coronary vasoreactivity were assessed in all patients. Results: Of the 20 patients included, the mean age was 63±13 years and 50% were females. Most patients had persistent typical angina and evidence of ischemia in noninvasive tests (75%). The CFT was successfully performed in all subjects without serious complications. Isolated MVA was found in 25%, isolated VSA in 40%, both MVA and VSA in 10% and noncardiac chest pain in 25% of patients. Antianginal therapy was modified after the results of CFT in 70% of patients. Conclusion: A coronary function test was feasible and safe in a cohort of patients with ANOCA. CVD were prevalent in this selected group of patients, and some presented mixed CVD phenotypes. CFT may provide a definitive diagnosis in patients with persistent angina and prompt the stratification of pharmacological therapy.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol . 2023 May;42(5):455-465.pt_PT
dc.identifier.doi10.1016/j.repc.2022.05.011pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4624
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectHumanspt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Disease* / diagnosispt_PT
dc.subjectCoronary Vesselspt_PT
dc.subjectFractional Flow Reserve, Myocardial*pt_PT
dc.subjectIschemiapt_PT
dc.subjectMicrovascular Angina* / diagnosispt_PT
dc.subjectMicrovascular Angina* / epidemiologypt_PT
dc.titleInitial Single-Center Experience of a Standardized Protocol for Invasive Assessment of Ischemia and Non-Obstructive Coronary Artery Diseasept_PT
dc.title.alternativeProtocolo Sistematizado para Avaliação Invasiva de Isquémia em Doentes Sem Doença Coronária Obstrutiva. Experiência Inicial de um Centropt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage465pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage455pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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