<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2604-7306</journal-id>
<journal-title><![CDATA[REC: Interventional Cardiology]]></journal-title>
<abbrev-journal-title><![CDATA[REC Interv Cardiol ES]]></abbrev-journal-title>
<issn>2604-7306</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cardiología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2604-73062023000400006</article-id>
<article-id pub-id-type="doi">10.24875/recic.m23000376</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estudio de la vasorreactividad y la función microvascular por termodilución en ausencia de enfermedad coronaria obstructiva]]></article-title>
<article-title xml:lang="en"><![CDATA[Thermodilution assessment of vasoreactivity and microvascular function in the absence of obstructive coronary artery disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Federico-Zaragoza]]></surname>
<given-names><![CDATA[Pau]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castelló-Viguer]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Ortiz-de Urbina]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Planas-del Viejo]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peris-Domingo]]></surname>
<given-names><![CDATA[Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pomar-Domingo]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario La Ribera Servicio de Cardiología ]]></institution>
<addr-line><![CDATA[Alzira Valencia]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>5</volume>
<numero>4</numero>
<fpage>270</fpage>
<lpage>278</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2604-73062023000400006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2604-73062023000400006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2604-73062023000400006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción y objetivos: El diagnóstico invasivo de la vasorreactividad y la función microvascular puede resultar de utilidad para optimizar el manejo de los pacientes con signos o síntomas de isquemia miocárdica en ausencia de estenosis coronarias significativas (INOCA). Se analizó la prevalencia de los distintos endotipos y la concordancia entre 2 métodos diagnósticos basados en la termodilución.  Métodos: Se incluyeron de forma prospectiva 60 pacientes con INOCA a quienes se realizó un test de vasorreactividad con acetilcolina intracoronaria, medida del flujo absoluto (Q) y la resistencia microvascular mínima (R) por termodilución continua y, por último, se calcularon la reserva de flujo coronario (RFC) y el índice de resistencia microvascular (IRM) por termodilución con bolos. Se consideraron como patológicos los puntos de corte establecidos de RFC &lt; 2 e IRM &#8805; 25.  Resultados: El procedimiento diagnóstico funcional invasivo permitió clasificar a los pacientes en 4 subgrupos: disfunción microvascular (40%), vasoespasmo epicárdico (17%), trastorno mixto (20%) y estudio normal (23%). No se observó correlación entre Q y RFC. Mediante curvas ROC se estimó una R &gt; 435 UW como el punto de corte óptimo para identificar pacientes con IRM &#8805; 25, con un área bajo la curva de 0,67 (IC95%, 0,51-0,82; p = 0,04).  Conclusiones: El estudio invasivo de la vasorreactividad y la microcirculación fue factible y seguro. La prevalencia de vasoespasmo y de disfunción microvascular en pacientes con INOCA fue elevada. El análisis conjunto de RFC, IRM y Q permitió desenmascarar un subtipo de disfunción microvascular caracterizado por un flujo coronario basal anormalmente elevado. La concordancia entre la resistencia microvascular obtenida por termodilución continua respecto al método de referencia fue baja, por lo que se requieren futuros estudios para determinar la utilidad de esta técnica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction and objectives: Invasive diagnosis of vasoreactivity and microvascular function may be useful to optimize the management of patients with signs and/or symptoms of myocardial ischemia in the absence of significant coronary stenosis (INOCA). We analyzed the prevalence of the different endotypes, as well as the concordance between 2 diagnostic methods based on thermodilution assessment.  Methods: We prospectively included 60 patients with INOCA who underwent a vasoreactivity test with intracoronary acetylcholine, and measurement of absolute coronary blood flow (Q) and minimum microvascular resistance (R) using continuous thermodilution assessment. Finally, calculations of the coronary flow reserve (CFR) and index of microcirculatory resistance index (IMR) were made using the bolus thermodilution method considering CFR &lt; 2 and MRI &#8805; 25 as established pathological cut-off values.  Results: The invasive functional diagnostic procedure allowed patients to be categorized into 4 subgroups: microvascular dysfunction (40%), epicardial vasospasm (17%), mixed disorder (20%), and normal study (23%). No correlation was seen between the Q and the CFR. Using ROC curves, an R &gt; 435 UW was estimated as the optimal cut-off value to identify patients with IMR &#8805; 25 with an area under the curve of 0.67 (95%CI, 0.51-0.82; P = .04).  Conclusions: The invasive study of vasoreactivity and microcirculation was feasible and safe. Prevalence of vasospasm and microvascular dysfunction in patients with INOCA was high. The CFR/MRI/Q combined study allowed us to unmask a subtype of microvascular dysfunction characterized by an abnormally high coronary flow at baseline. The concordance seen between the microvascular resistance obtained by continuous thermodilution measurements and the reference method was low so future studies are justified to determine the usefulness of this technique.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Disfunción microvascular]]></kwd>
<kwd lng="es"><![CDATA[Vasoespasmo]]></kwd>
<kwd lng="es"><![CDATA[Acetilcolina]]></kwd>
<kwd lng="es"><![CDATA[Termodilución continua]]></kwd>
<kwd lng="es"><![CDATA[Resistencia microvascular]]></kwd>
<kwd lng="es"><![CDATA[INOCA]]></kwd>
<kwd lng="en"><![CDATA[Microvascular dysfunction]]></kwd>
<kwd lng="en"><![CDATA[Vasospasm]]></kwd>
<kwd lng="en"><![CDATA[Acetylcholine]]></kwd>
<kwd lng="en"><![CDATA[Continuous thermodilution measurements]]></kwd>
<kwd lng="en"><![CDATA[Microvascular resistance]]></kwd>
<kwd lng="en"><![CDATA[INOCA]]></kwd>
</kwd-group>
</article-meta>
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