ArticleInternational journal of cardiology2020
Ambulatory and silent myocardial ischemia in women with coronary microvascular dysfunction: Results from the Cardiac Autonomic Nervous System study (CANS).
Article in International journal of cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- The Diagnostic Value of ECG Characteristics for Vasospastic and Microvascular Angina: A Systematic Review.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Pooled it
- Sex differences in cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention.Journal of thoracic disease · 2025Article
- Ischemia with Non-Obstructive Coronary Artery Disease: Sex-Based Differences in Pathophysiology, Clinical Presentation, and Prognosis.Journal of clinical medicine · 2025Review
- Parasympathetic response in women with coronary vascular dysfunction during mental stress compared to those with non-cardiac chest pain and reference controls.International journal of cardiology. Heart & vasculature · 2025Article
- A proposed model using glycation metrics and circulating biomarkers for the prevention of cardiovascular disease.Frontiers in medicine · 2025Article
- Skin sympathetic nerve activity and ST-segment depression in women.Heart rhythm O2 · 2024Article
- The Role of Coronary Physiology Assessment in the Diagnosis and Treatment of Stable Angina. Dive Inside Recent Findings of Diffuse Coronary Disease Treatment.Reviews in cardiovascular medicine · 2024Review
- Evaluation of Outpatients in the Post-COVID-19 Period in Terms of Autonomic Dysfunction and Silent Ischemia.Cureus · 2023Article
- Latest from the WISE: Contributions to the Understanding of Ischemia and Heart Failure among Women with No Obstructive Coronary Arteries.Reviews in cardiovascular medicine · 2023Review
- Ischemia and no obstructive coronary arteries (INOCA): A narrative review.Atherosclerosis · 2022Review
- Diastolic dysfunction in women with ischemia and no obstructive coronary artery disease: Mechanistic insight from magnetic resonance imaging.International journal of cardiology · 2021Article
- Microvascular Angina: Diagnosis and Management.European cardiology · 2021Review
- Impaired coronary flow velocity reserve is associated with cardiovascular risk factors but not with angina symptoms.Open heart · 2021Article
- Gender-Related Differences in Chest Pain Syndromes in the Frontiers in CV Medicine Special Issue: Sex & Gender in CV Medicine.Frontiers in cardiovascular medicine · 2021Review
- Doppler Echocardiography Assessment of Coronary Microvascular Function in Patients With Angina and No Obstructive Coronary Artery Disease.Frontiers in cardiovascular medicine · 2021Review
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundUp to two-thirds of patients with obstructive coronary artery disease (CAD) have silent ischemia (SI), which predicts an adverse prognosis and can be a treatment target in obstructive CAD. Over 50% of women with ischemia and no obstructive CAD have coronary microvascular dysfunction (CMD), which is associated with adverse cardiovascular outcomes. We aimed to investigate the prevalence of SI in CMD in order to consider it as a potential treatment target.
methods36 women with CMD by coronary reactivity testing and 16 age matched reference subjects underwent 24-h 12-lead ambulatory ECG monitoring (Mortara Instruments) after anti-ischemia medication withdrawal. Ambulatory ECG recordings were reviewed by two-physician consensus masked to subject status for SI measured by evidence of ≥1 minute horizontal or downsloping ST segment depression ≥1.0 mm, measured 80 ms from the J point.
resultsDemographics, resting heart rate, and systolic blood pressure were similar between CMD and reference subjects. Thirty-nine percent of CMD women had a total of 26 SI episodes vs. 0 episodes in the reference group (p = 0.002). Among these women 13/14 (93%) had SI, and few episodes (3/26, 12%) were symptomatic. Mean HR at the onset of SI was 96 ± 13 bpm and increased to 117 ± 16 bpm during the ischemic episodes. 87% reported symptoms that were not associated with ST depressions.
conclusionsAmbulatory ischemia is prevalent in women with CMD, with a majority being SI, while most reported symptoms were not accompanied by ambulatory ischemia. Clinical trials evaluating anti-ischemic medications should be considered in the CMD population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.