Evidence map›Paper›PMID 37719976›Full record

ArticleFrontiers in cardiovascular medicine2023

The relationships between acetylcholine-induced chest pain, objective measures of coronary vascular function and symptom status.

Steven E S Miner, Mary C McCarthy, Chris I Ardern, Chris G R Perry, Olga Toleva, Lynne E Nield, Cedric Manlhiot, Warren J Cantor

Abstract read
In one paragraph

Article in Frontiers in cardiovascular medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Invasive Endotyping of Angina Pectoris with Nonobstructive Coronary Arteries.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025
    Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Steven E S MinerDivision of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada.
Mary C McCarthyDivision of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada.
Chris I ArdernSchool of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, ON, Canada.
Chris G R PerrySchool of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, ON, Canada.
Olga TolevaDepartment of Cardiology, Emory University, Atlanta, GA, United States.
Lynne E NieldDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Cedric ManlhiotThe Blalock-Taussig-Thomas Pediatric and Congenital Heart Center, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States.
Warren J CantorDivision of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acetylcholine-induced chest pain is routinely measured during the assessment of microvascular function. Aims: The aim was to determine the relationships between acetylcholine-induced chest pain and both symptom burden and objective measures of vascular function. Methods: In patients with angina but no obstructive coronary artery disease, invasive studies determined the presence or absence of chest pain during both acetylcholine and adenosine infusion. Thermodilution-derived coronary blood flow (CBF) and index of microvascular resistance (IMR) was determined at rest and during both acetylcholine and adenosine infusion. Patients with epicardial spasm (>90%) were excluded; vasoconstriction between 20% and 90% was considered endothelial dysfunction. Results: Eighty-seven patients met the inclusion criteria. Of these 52 patients (60%) experienced chest pain during acetylcholine while 35 (40%) did not. Those with acetylcholine-induced chest pain demonstrated: (1) Increased CBF at rest (1.6 ± 0.7 vs. 1.2 ± 0.4, Conclusions: After excluding epicardial spasm, acetylcholine-induced chest pain is associated with increased pain during exercise and adenosine infusion, increased coronary blood flow at rest, decreased microvascular resistance in response to acetylcholine and increased prevalence of epicardial endothelial dysfunction. These findings raise questions about the mechanisms underlying acetylcholine-induced chest pain.

Indexed as

coronary endothelial dysfunctionfractional flow reservemicrovascular anginamicrovascular dysfunctionstable anginavasospastic angina

Identifiers

PMID37719976
PMCPMC10501450

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.