Investigating microvascular function as a potential cause of angina in coronary artery disease.

This study investigated if the incidence of coronary microvascular dysfunction in patients with ischemic heart disease.

They found that microvascular dysfunction is present in patients with angina.

Coronary arteries are responsible for supplying the heart with blood and oxygen. Coronary artery disease (CAD) is caused by a build-up of fatty tissue in the coronary arteries. This can result in reduced blood flow to the heart and lead to a heart attack. Non-obstructive CAD is a blockage that would not be expected to affect blood flow or cause angina.

Angina, or chest pain, is a symptom of CAD. The cause of angina is not always clear. In most cases it can be caused by blockages in the main coronary arteries. It may also be caused by blockages in smaller blood vessels (microvascular), however this is more difficult to detect. Patients with non-obstructive CAD can sometimes report angina symptoms. This is believed to be caused by microvascular angina.

Angiography is a procedure to assess blood flow through blood vessels. Advances in angiography techniques could provide more information on microvascular angina.

This study investigated the incidence of microvascular angina in patients with CAD.

This study included 1202 patients with angina and CAD. 63 of these patients had microvascular function measured. Patients were randomly assigned to one of three groups. Two groups underwent angiography procedures – cardiovascular magnetic resonance (CMR) or myocardial perfusion scintigraphy (MPS). The third group did not undergo a procedure but were monitored using standard care procedure by the National Institute for Health and Care Excellence (NICE). The functioning of the coronary arteries and microvessels were assessed during the study.

68% of patients with non-obstructive CAD and angina had abnormal microvascular function. 39% of patients with obstructive CAD also had abnormal microvascular function.

The authors concluded that microvascular dysfunction is often present in patients with angina.

75% of patients in this study were male. A relatively small number of of the 1202 CAD patients underwent full assessment of microvascular function, so further studies are needed.

If you have any concerns regarding angina and CAD please consult with your doctor.