Microvascular Resistance Reserve vs Coronary Flow Reserve to Assess Age-Related Trends in Coronary Microvascular Dysfunction

JACC: Cardiovascular Interventions 2026 Open access

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Authors: Timo Nijkamp, Hanae F. Namba, Coen K.M. Boerhout, Joo Myung Lee, Guus A. de Waard, Hernán Mejía‐Rentería, Masahiro Hoshino, Mauro Echavarría-Pinto, Martijn Meuwissen, Hitoshi Matsuo, Maribel Madera‐Cambero, Ashkan Eftekhari
+23 more Mohamed A. Effat, Rupak K. Banerjee, Tadashi Murai, Koen Marques, Joon-Hyung Doh, Ji Hyun Jung, Chang-Wook Nam, Giampaolo Niccoli, Masafumi Nakayama, Nobuhiro Tanaka, Eun‐Seok Shin, René van Es, Hester M. den Ruijter, Pim van der Harst, Paul Knaapen, Bon-Kwon Koo, Tsunekazu Kakuta, Javier Escaned, Niels van Royen, Evald H. Christiansen, Jan J. Piek, Peter Damman, Tim P. van de Hoef
DOI: 10.1016/j.jcin.2025.11.019
Cited by: 4
References: 19

Abstract

BACKGROUND: Advancing age is associated with epicardial atherosclerosis and coronary microvascular dysfunction (CMD), complicating reliable assessment of CMD using coronary flow reserve (CFR). Whether prevalence of functional and structural CMD varies with age remains unclear. OBJECTIVES: The authors sought to evaluate the prevalence of CMD endotypes by age strata and compare CFR with microvascular resistance reserve (MRR) for diagnosis and stratification. METHODS: Data from 1,704 patients (2,283 lesions) with stable angina in the ILIAS Registry (Inclusive Invasive Physiological Assessment in Angina Syndromes Registry) were analyzed, including obstructive (fractional flow reserve ≤0.80) and nonobstructive (fractional flow reserve >0.80) lesions. CMD was classified as no CMD (MRR ≥3.0), functional CMD (MRR

Fields of Study & Subjects

Cardiac Imaging and Diagnostics Cardiovascular Disease and Adiposity Cardiovascular Function and Risk Factors

Publication details

Journal / source
JACC: Cardiovascular Interventions
Publisher
Elsevier BV
Volume
19
Issue
4
Pages
437–448
Publication date
9 January 2026
Language
EN