This single-arm, multi-center, prospective study will assess the coronary flow reserve (CFR), index of microcirculatory resistance (IMR), and determinants thereof (transit time, Pa, Pd) in patients before and after intracoronary nitroglycerine.
Aged 18 or older
Patient being evaluated for ANOCA or INOCA
Clinical suspicion for angina
Patient should be able to comply with the protocol.
Existing coronary artery disease
Previous percutaneous interventions within the coronaries
Current use (within 48 hours) of long-acting nitrate therapies
Current use (within 48 hours) of PDE-5 inhibitors (sildenafil, tadalafil)
Single group
Coronary reactivity testing with and without nitrates
Diagnostic testCRT will be performed in the left and right coronary arteries. Measurements will be obtained in each of the coronaries first without intracoronary nitrates followed by a dose of 200-500 mcg of intracoronary nitrates and repeat measurements.
Assessment of CFR by CRT before and after nitrates
The primary outcome will be comparing the variables assessed by CRT with the primary outcome being CFR before and after nitroglycerin administration.
IMR, HMR, Pd/Pa, RRR, RFR, and transit times before and after nitrates.
The secondary outcomes will be IMR, Pd, Pa, RRR, and transit times before and after nitrates.
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