Prognostic Implications of Coronary Microvascular Dysfunction Assessed by Continuous Thermodilution in Patients with Angina and non obstructive coronary arteries

Abstract Background: Coronary microvascular dysfunction (CMD) is increasingly recognized as a key contributor to persistent angina in patients with non-obstructive coronary arteries (ANOCA). Traditional angiography often fails to detect microvascular abnormalities, and newer methods such as continuous thermodilution allow for direct physiologic assessment of coronary microvascular function. However, the prognostic significance of CMD measured by continuous thermodilution in this population remains incompletely defined. Objectives: To evaluate the prognostic implications of CMD, as quantified by continuous thermodilution–derived coronary flow reserve (CFR) and microvascular resistance indices, in patients with angina and non-obstructive coronary arteries. Methods: We conducted a prospective cohort study of 200 patients presenting with angina and undergoing clinically indicated coronary angiography without obstructive epicardial stenosis (