Vasomotor dysfunction in patients with angina and nonobstructive coronary artery disease is dominated by vasospasm

BackgroundCoronary vasomotor dysfunction, comprising endotypes of coronary spasm and/or impaired microvascular dilatation (IMD), is common in patients with angina and no obstructive arteries (ANOCA). However, there are discrepant reports regarding the prevalence these endotypes. The objective this study was to determine dysfunction ANOCA, underlying endotypes, differences clinical characteristics.MethodsProspective registry ANOCA that underwent clinically indicated invasive function testing (CFT), including acetylcholine (2–200 μg) diagnose spasm, adenosine (140 μg/kg/min) IMD, defined as an index resistance ≥25 flow reserve <2.0.ResultsOf 111 completed CFT (88% female, mean age 54 years), 96 (86%) showed dysfunction. majority 93 (97%) had 63% isolated 34% combined IMD. Isolated IMD rare, occurring only 3 (3%). Hypertension more prevalent compared those without (39% vs. 7%, p = 0.02). Obesity a higher severity angiographic atherosclerotic disease were (61% 28%; 40% 0%, respectively, both < 0.01). No characteristics observed between or endotypes.ConclusionsCoronary highly especially epicardial vasospasm, whereas rare. Performing should be strongly discouraged.