{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:50:18Z","timestamp":1792068618645,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T00:00:00Z","timestamp":1397001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,8]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>The exercise electrocardiogram (ECG<\/jats:styled-content>) is a standard examination in patients with suspected coronary artery disease. However, despite a pathologic result, many patients undergoing diagnostic coronary angiography do not have any significant epicardial stenosis. In this study, we assessed the relation between a pathologic exercise ECG<\/jats:styled-content> and coronary microvascular dysfunction in response to intracoronary acetylcholine (ACh<\/jats:styled-content>) provocation in patients without any relevant epicardial stenosis.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>Coronary microvascular dysfunction is significantly more often in patients with angina, unobstructed coronary arteries and a pathologic exercise stress test compared to those without pathologic stress test.<\/jats:p><\/jats:sec>Methods<\/jats:title>This study recruited 137 consecutive patients with exertional angina pectoris who underwent diagnostic coronary angiography between September 2008 and April 2011 (68% women; mean age, 63\u2009\u00b1\u200910\u2009years). In none of the patients was there a stenosis of >50%. All patients underwent an exercise ECG<\/jats:styled-content> before angiography and intracoronary ACh<\/jats:styled-content> provocation testing for assessment of coronary vasomotor responses directly after angiography.<\/jats:p><\/jats:sec>Results<\/jats:title>The exercise ECG<\/jats:styled-content> showed an abnormal result in 69 patients (50%; ST<\/jats:styled-content>\u2010segment depression \u22650.1 mV<\/jats:styled-content> and\/or reproduction of the patient's usual symptoms). The ACh<\/jats:styled-content> test revealed a coronary vasomotor abnormality (reproduction of the patient's symptoms, ischemic ECG<\/jats:styled-content> shifts\u2009\u00b1\u2009diffuse distal vasoconstriction) in 87 patients (64%). Such a result was significantly more often found in patients with a pathologic exercise ECG<\/jats:styled-content> (50\/69 [72%] vs 19\/69 [28%], P<\/jats:italic> = 0.034). There were no other statistically significant differences between patients with and those without pathologic exercise ECG<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Coronary microvascular dysfunction is frequently found in patients with exertional angina pectoris and unobstructed coronary arteries. Such a finding is found significantly more often in presence of a pathologic exercise ECG<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22282","type":"journal-article","created":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T17:27:33Z","timestamp":1397064453000},"page":"462-467","source":"Crossref","is-referenced-by-count":44,"title":["Coronary Microvascular Dysfunction Assessed by Intracoronary Acetylcholine Provocation Testing Is a Frequent Cause of Ischemia and Angina in Patients With Exercise\u2010Induced Electrocardiographic Changes and Unobstructed Coronary Arteries"],"prefix":"10.1002","volume":"37","author":[{"given":"Peter","family":"Ong","sequence":"first","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Athanasiadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Sch\u00e4ufele","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Mahrholdt","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Sechtem","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.11.015"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.073"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-012-6382-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2001.114198"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.067330"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000116601.58103.62"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1549-8719.2009.00015.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp205"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra061889"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-012-0442-4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80122-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvn136"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e328351680f"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012369"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.174367"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.12.070"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.108.841056"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.07.011"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00478-0"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960220513"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl040"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr331"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht395"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.05.034"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22282","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T08:12:53Z","timestamp":1696579973000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,9]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1002\/clc.22282"],"URL":"https:\/\/doi.org\/10.1002\/clc.22282","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,9]]}}}