Clinical and imaging variables associated to Microvascular Angina, a 13N-AMMONIA MPI Approach

Funding Acknowledgements Type of funding sources: None. On Behalf of MiniFellows Research Group CLINICAL AND IMAGING VARIABLES IN MICROVASCULAR ANGINA. A 13N-AMMONIA MPI APPROACH Background Patients with typical angina may have no obstructive artery disease1 and 2/3 may present microvascular dysfunction(MVD)2 which is associated with poor prognosis3,4,5. In 2017 the Coronary Vasomotion Disorders International Study Group (COVADIS) included it as a criteria of MVA6; later, included in MINOCA ESC 2020 guidelines.7 For diagnosis6,7: symptoms of ischemia; absence of relevant epicardial CAD (0.80); myocardial ischemia; impaired coronary microvascular function (CFR Methods.Retrospective, cross-sectional study of patients with suspected CAD. For inclusion: ischemia quantitation (summed stress score,SDS Results 274 patients included: Group A (CFR Discussion With a higher prevalence reported in women8,9, no difference for women in both groups. Presentation been reported as atypical 3,6,10, as in our study. Traditional risk factors may affect the microvascular circulation earlier in the disease. Regarding mild and severe ischemia, CFR´s may be lower in defect perfusion zones and presence of both ischemia and MVD has worse prognosis11 suggesting ischemia could had already developed in this group. LVEF drop supports the relation between CFR and ventricular function12. Finally, MVA group had a reduced CS, associated with CAD and worse prognosis, suggesting it also affects the microvasculature function. Conclusions 13N-ammonia PET/CT MPI with CCTA is a great combination to diagnose MVA, whose main component is microvascular dysfunction. Recognizing the risk factors associated with this pathology allows making opportune detections, implementing early treatment strategies, controlling symptoms and avoiding the disease"s evolution