Sex difference of coronary microvascular dysfunction evaluated by coronary flow reserve will be assessed in patients with non-obstructive coronary artery disease
Typical/atypical chest pain or ischemic symptoms including dyspnea
No significant coronary artery stenosis (<50% stenosis) in coronary angiography or computed tomography
≥ Moderate valvular heart disease
Congenital heart disease
Chronic renal failure (estimated glomerular filtration rate <30 ml/min/1.73m2) or end-stage renal failure undergoing hemodialysis or peritoneal dialysis
Asthma, chronic obstructive pulmonary disease and primary pulmonary hypertension
Consecutive patients who experienced chest pain but with no obstructed coronary arteries (\<50% stenosis)
Cohort
Prospective
Adenosine stress echocardiography
Diagnostic testTransthoracic echocardiographic assessments will be performed using an ultrasound device (Vivid E95, General Electric Healthcare, Liestal, Switzerland). Color Doppler flow of the distal left anterior descending artery was examined from the modified apical four-chamber view of the anterior interventricular groove. Pulsed-wave Doppler registered blood flow velocity patterns using a sample volume (2-3.0 mm) placed on the color signal. The ultrasound beam was aligned parallel to the vessel flow. The velocity scale of color Doppler was set to 0.21 m/s. Coronary flow Doppler images were acquired at baseline and at 1, 2, and 3 min after adenosine infusion in the same part of the artery. Anti-anginal medications, including calcium channel blockers, were discontinued before the study.
A composite outcome including all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure
Number of participants with a composite outcome including all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure
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