Changes in absolute coronary flow and microvascular resistance during exercise in patients with ANOCA

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BACKGROUND: Whether saline-induced hyperaemia captures exercise-induced coronary flow regulation remains unknown. AIMS: Through this study, we aimed to describe absolute coronary flow (Q) and microvascular resistance (Rμ) adaptation during exercise in participants with angina with non-obstructive coronary artery disease (ANOCA) and to explore the correlations between saline- and exercise-derived coronary flow reserve (CFR) and microvascular resistance reserve (MRR). METHODS: ) cutoff <2.5 was used to identify coronary microvascular dysfunction (CMD). RESULTS: <2.5 at the peak of exercise due to a moderate and late decrease of Rμ. CONCLUSIONS: Saline-induced hyperaemia provided a valid surrogate for exercise physiology independently of the absolute level of CFR and MRR, although exercise provided more granularity to evaluate adaptation among participants with exercise-related CMD.