{"doi":"10.1136/openhrt-2023-002437","title":"Primary versus iatrogenic (post-PCI) coronary microvascular dysfunction: a wire-based multimodal comparison","abstract":"<jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Although there are studies examining each one separately, there are no data in the literature comparing the magnitudes of the iatrogenic, percutaneous coronary intervention (PCI)-induced, microvascular dysfunction (Type-4 CMD) and coronary microvascular dysfunction (CMD) in the setting of ischaemia in non-obstructed coronary arteries (INOCA) (Type-1 CMD).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>We aimed to compare the characteristics of Type-1 and Type-4 CMD subtypes using coronary haemodynamic (resistance and flow-related parameters), thermodynamic (wave energy-related parameters) and hyperemic ECG changes.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Coronary flow reserve (CFR) value of &lt;2.5 was defined as CMD in both groups. Wire-based multimodal perfusion markers were comparatively analysed in 35 patients (21 INOCA/CMD and 14 CCS/PCI) enrolled in <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05471739\">NCT05471739</jats:ext-link> study.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Both groups had comparably blunted CFR values per definition (2.03±0.22 vs 2.11±0.37; p: 0.518) and similar hyperemic ST shift in intracoronary ECG (0.16±0.09 vs 0.18±0.07 mV; p: 0.537). While the Type-1 CMD was characterised with impaired hyperemic blood flow acceleration (46.52+12.83 vs 68.20+28.63 cm/s; p: 0.017) and attenuated diastolic microvascular decompression wave magnitudes (p=0.042) with higher hyperemic microvascular resistance (p&lt;0.001), Type-4 CMD had blunted CFR mainly due to higher baseline flow velocity due to post-occlusive reactive hyperemia (33.6±13.7 vs 22.24±5.3 cm/s; p=0.003).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>The perturbations in the microvascular milieu seen in CMD in INOCA setting (Type-1 CMD) seem to be more prominent than that of seen following elective PCI (Type-4 CMD), although resulting reversible ischaemia is equally severe in the downstream myocardium.</jats:p>\n               </jats:sec>","journal":"Open Heart","year":2023,"id":650671,"datarank":0.38474240361923057,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"self_citation_contribution":0.38474240361923057,"citation_network_contribution":0.0,"self_endowment_contribution":0.38474240361923057,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1696629,"name":"Ahmet Taş","orcid":"0000-0002-1944-2576","position":1,"is_corresponding":false},{"id":1696630,"name":"Erdem Cevik","orcid":null,"position":2,"is_corresponding":false},{"id":1696631,"name":"Yaren Alan","orcid":null,"position":3,"is_corresponding":false},{"id":1696632,"name":"Christopher J Broyd","orcid":null,"position":4,"is_corresponding":false},{"id":641761,"name":"Alp Ozcan","orcid":"0000-0002-5558-6155","position":5,"is_corresponding":false},{"id":1696633,"name":"Mehmet R Sonsoz","orcid":null,"position":6,"is_corresponding":false},{"id":1696634,"name":"Ilke Kara","orcid":null,"position":7,"is_corresponding":false},{"id":1696636,"name":"Zeynep G Demirtakan","orcid":null,"position":8,"is_corresponding":false},{"id":1696638,"name":"Kim Parker","orcid":null,"position":9,"is_corresponding":false},{"id":1022996,"name":"Divaka Perera","orcid":"0000-0001-6362-1291","position":10,"is_corresponding":false},{"id":1696640,"name":"Sabahattin Umman","orcid":null,"position":11,"is_corresponding":false},{"id":1696641,"name":"Murat Sezer","orcid":"0000-0001-9614-1614","position":12,"is_corresponding":false},{"id":1696627,"name":"Hakan Hasdemir","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Primary versus iatrogenic (post-PCI) coronary microvascular dysfunction: a wire-based multimodal comparison","abstract":"<jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Although there are studies examining each one separately, there are no data in the literature comparing the magnitudes of the iatrogenic, percutaneous coronary intervention (PCI)-induced, microvascular dysfunction (Type-4 CMD) and coronary microvascular dysfunction (CMD) in the setting of ischaemia in non-obstructed coronary arteries (INOCA) (Type-1 CMD).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>We aimed to compare the characteristics of Type-1 and Type-4 CMD subtypes using coronary haemodynamic (resistance and flow-related parameters), thermodynamic (wave energy-related parameters) and hyperemic ECG changes.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Coronary flow reserve (CFR) value of &lt;2.5 was defined as CMD in both groups. Wire-based multimodal perfusion markers were comparatively analysed in 35 patients (21 INOCA/CMD and 14 CCS/PCI) enrolled in <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05471739\">NCT05471739</jats:ext-link> study.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Both groups had comparably blunted CFR values per definition (2.03±0.22 vs 2.11±0.37; p: 0.518) and similar hyperemic ST shift in intracoronary ECG (0.16±0.09 vs 0.18±0.07 mV; p: 0.537). While the Type-1 CMD was characterised with impaired hyperemic blood flow acceleration (46.52+12.83 vs 68.20+28.63 cm/s; p: 0.017) and attenuated diastolic microvascular decompression wave magnitudes (p=0.042) with higher hyperemic microvascular resistance (p&lt;0.001), Type-4 CMD had blunted CFR mainly due to higher baseline flow velocity due to post-occlusive reactive hyperemia (33.6±13.7 vs 22.24±5.3 cm/s; p=0.003).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>The perturbations in the microvascular milieu seen in CMD in INOCA setting (Type-1 CMD) seem to be more prominent than that of seen following elective PCI (Type-4 CMD), although resulting reversible ischaemia is equally severe in the downstream myocardium.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":null,"pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by-nc","oa_locations":[{"url":"https://openheart.bmj.com/content/openhrt/10/2/e002437.full.pdf","host_type":"publisher"},{"url":"https://syndication.highwire.org/content/doi/10.1136/openhrt-2023-002437","host_type":"publisher"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10685972/pdf/openhrt-2023-002437.pdf","host_type":"repository"},{"url":"https://doaj.org/article/e4e99a52cb8b4b92925e084edb1158a9","host_type":"repository"}],"fields_of_study":[],"mesh_terms":[],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T05:54:36.609352Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}