{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:38:09Z","timestamp":1793374689586,"version":"4.5.0"},"reference-count":116,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic coronary disease remains a complex condition for which non-invasive imaging is central to diagnosis, risk stratification, follow-up, and management. An understanding of contemporary clinical practice guidelines is critical to appropriate test selection, avoidance of low-value testing, and individualized care. This review compares the contemporary European Society of Cardiology guideline and the American College of Cardiology\/American Heart Association guideline regarding non-invasive imaging for chronic coronary disease\/syndromes. The European and American guidelines are broadly concordant in supporting clinical likelihood assessment before testing, selective use of coronary computed tomography angiography (CCTA) and functional imaging, and avoidance of routine surveillance testing in clinically stable patients. However, several distinctions emerge. First, the European guideline provides a more prescriptive diagnostic algorithm for suspected chronic coronary syndromes, using pre-test likelihood thresholds to guide deferral of testing, CCTA, functional imaging, and invasive angiography, whereas the American guideline is more focused on established chronic coronary disease, symptom change, functional decline, and whether testing will alter management. Second, the European guideline assigns a stronger early role to CCTA, particularly in low-to-moderate likelihood patients, and provides more high-risk anatomic and ischaemic imaging thresholds. Third, the guidelines differ in the positioning of exercise electrocardiography and in the diagnostic evaluation of angina or ischaemia with non-obstructive coronary arteries, microvascular angina, and vasospastic angina. The latest European Society of Cardiology (ESC) guideline remains more diagnosis-forward and algorithmic, whereas the American College of Cardiology\/American Heart Association (ACC\/AHA) guideline is more management-forward and symptom-driven. These differences may influence imaging selection, repeat testing, and evaluation of non-obstructive coronary syndromes.<\/jats:p>","DOI":"10.1093\/ehjci\/jeag259","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:07:15Z","timestamp":1789474035000},"page":"1984-2001","source":"Crossref","is-referenced-by-count":0,"title":["ESC vs. ACC\/AHA guidelines for non-invasive imaging in chronic coronary disease: guideline discordance, gaps, and future directions"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2112-6196","authenticated-orcid":false,"given":"Anas","family":"Bader","sequence":"first","affiliation":[{"name":"School of Medicine, University College Dublin , Belfield, Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adham","family":"Elsherbini","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-4510","authenticated-orcid":false,"given":"Kevin R","family":"An","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, St. Michael\u2019s Hospital, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, NewYork-Presbyterian Hospital\/Columbia University Irving Medical Center , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2583-9278","authenticated-orcid":false,"given":"Andrew J","family":"Einstein","sequence":"additional","affiliation":[{"name":"Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital\/Columbia University Irving Medical Center , New York, NY ,","place":["USA"]},{"name":"Department of Radiology, Columbia University Irving Medical Center\/NewYork-Presbyterian Hospital , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick Y","family":"Tam","sequence":"additional","affiliation":[{"name":"Schulich Heart Centre, Sunnybrook Health Sciences Centre , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]},{"name":"Division of Cardiac Surgery, University of Toronto , 149 College Street, 5th Floor, Toronto, Ontario M5T 1P5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026103011094883400_jeag259-B1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2991\/jegh.k.201217.001","article-title":"Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: a narrative review","volume":"11","author":"Ralapanawa","year":"2021","journal-title":"J Epidemiol Glob Health"},{"key":"2026103011094883400_jeag259-B2","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.3390\/diagnostics13122083","article-title":"The role of non-invasive multimodality imaging in chronic coronary syndrome: anatomical and functional pathways","volume":"13","author":"Bergamaschi","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"2026103011094883400_jeag259-B3","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.124.017567","article-title":"Temporal trends in noninvasive and invasive cardiac testing from 2010 to 2022 in the US Medicare population","volume":"18","author":"Cohen","year":"2025","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B4","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1056\/NEJMoa1716734","article-title":"Magnetic resonance perfusion or fractional flow reserve in coronary disease","volume":"380","author":"Nagel","year":"2019","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1056\/NEJMoa1805971","article-title":"Coronary CT angiography and 5-year risk of myocardial infarction","volume":"379","author":"SCOT-HEART Investigators","year":"2018","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B6","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1056\/NEJMoa1915922","article-title":"Initial invasive or conservative strategy for stable coronary disease","volume":"382","author":"Maron","year":"2020","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B7","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B8","doi-asserted-by":"crossref","first-page":"e186","DOI":"10.1161\/CIR.0000000000001168","article-title":"2023 AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"148","author":"Virani","year":"2023","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B9","article-title":"The scale of scientific evidence behind the current ESC clinical guidelines","volume":"45","author":"Tantawy","year":"2023","journal-title":"Int J Cardiol Heart Vasc"},{"key":"2026103011094883400_jeag259-B10","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1016\/S0735-1097(19)33634-4","article-title":"Evolution of the American College of Cardiology and the American Heart Association cardiology clinical practice guidelines: a 10-year assessment","volume":"73","author":"Dubose-Briski","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B11","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1016\/j.jacc.2020.09.585","article-title":"Incorporating coronary calcification into pre-test assessment of the likelihood of coronary artery disease","volume":"76","author":"Winther","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B12","first-page":"e368","article-title":"2021 AHA\/ACC\/ASE\/CHEST\/SAEM\/SCCT\/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"144","author":"Gulati","year":"2021","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B13","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1056\/NEJMoa1415516","article-title":"Outcomes of anatomical versus functional testing for coronary artery disease","volume":"372","author":"Douglas","year":"2015","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B14","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1093\/eurheartj\/ehy267","article-title":"The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability","volume":"39","author":"Knuuti","year":"2018","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B15","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1161\/CIRCULATIONAHA.107.743963","article-title":"Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the clinical outcomes utilizing revascularization and aggressive drug evaluation (COURAGE) trial nuclear substudy","volume":"117","author":"Shaw","year":"2008","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B16","article-title":"2025 AHA\/ACC clinical performance and quality measures for patients with chronic coronary disease: a report of the American College of Cardiology\/American Heart Association joint committee on performance measures","volume":"18","author":"Williams","year":"2025","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026103011094883400_jeag259-B17","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.jacc.2013.11.052","article-title":"Yield of downstream tests after exercise treadmill testing: a prospective cohort study","volume":"63","author":"Christman","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B18","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1001\/jamacardio.2020.1567","article-title":"Exercise electrocardiography and computed tomography coronary angiography for patients with suspected stable angina pectoris: a post hoc analysis of the randomized SCOT-HEART trial","volume":"5","author":"Singh","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2026103011094883400_jeag259-B19","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1161\/CIRCULATIONAHA.111.029660","article-title":"Comparative effectiveness of exercise electrocardiography with or without myocardial perfusion single photon emission computed tomography in women with suspected coronary artery disease: results from the what is the optimal method for ischemia evaluation in women (WOMEN) trial","volume":"124","author":"Shaw","year":"2011","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B20","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1056\/NEJM199109193251204","article-title":"Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease","volume":"325","author":"Mark","year":"1991","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B21","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1136\/heartjnl-2023-322970","article-title":"Exercise electrocardiography for pre-test assessment of the likelihood of coronary artery disease","volume":"110","author":"Rasmussen","year":"2024","journal-title":"Heart"},{"key":"2026103011094883400_jeag259-B22","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jcmg.2021.11.019","article-title":"Comparison of pretest probability models of obstructive coronary artery disease","volume":"15","author":"Winther","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B23","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1093\/ehjci\/jez054","article-title":"Impact of a decreasing pre-test probability on the performance of diagnostic tests for coronary artery disease","volume":"20","author":"Juarez-Orozco","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B24","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1093\/eurheartj\/ehr014","article-title":"A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension","volume":"32","author":"Genders","year":"2011","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B25","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/jamacardio.2016.5501","article-title":"Identification of patients with stable chest pain deriving minimal value from noninvasive testing: the PROMISE minimal-risk tool, A secondary analysis of a randomized clinical trial","volume":"2","author":"Fordyce","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2026103011094883400_jeag259-B26","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/j.jcmg.2017.10.010","article-title":"Comprehensive cardiac CT with myocardial perfusion imaging versus functional testing in suspected coronary artery disease: the multicenter, randomized CRESCENT-II trial","volume":"11","author":"Lubbers","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B27","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1093\/eurheartj\/ehv700","article-title":"Calcium imaging and selective computed tomography angiography in comparison to functional testing for suspected coronary artery disease: the multicentre, randomized CRESCENT trial","volume":"37","author":"Lubbers","year":"2016","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B28","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1161\/CIRCULATIONAHA.117.030578","article-title":"Prognostic value of coronary artery calcium in the PROMISE study (prospective multicenter imaging study for evaluation of chest pain)","volume":"136","author":"Budoff","year":"2017","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B29","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1093\/ehjci\/jex014","article-title":"Comparison of the prognostic value of negative non-invasive cardiac investigations in patients with suspected or known coronary artery disease-a meta-analysis","volume":"18","author":"Smulders","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B30","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.114.002666","article-title":"Diagnostic accuracy of stress myocardial perfusion imaging compared to invasive coronary angiography with fractional flow reserve meta-analysis","volume":"8","author":"Takx","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B31","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1001\/jamacardio.2017.2471","article-title":"Comparison of coronary CT angiography, SPECT, PET, and hybrid imaging for diagnosis of ischemic heart disease determined by fractional flow reserve","volume":"2","author":"Danad","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2026103011094883400_jeag259-B32","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1016\/j.jcmg.2019.04.020","article-title":"Randomized comparison of clinical effectiveness of pharmacologic SPECT and PET MPI in symptomatic CAD patients","volume":"12","author":"Patel","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B33","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.nuclcard.2006.08.017","article-title":"Predicting therapeutic benefit from myocardial revascularization procedures: are measurements of both resting left ventricular ejection fraction and stress-induced myocardial ischemia necessary?","volume":"13","author":"Hachamovitch","year":"2006","journal-title":"J Nucl Cardiol"},{"key":"2026103011094883400_jeag259-B34","doi-asserted-by":"crossref","first-page":"2900","DOI":"10.1161\/01.CIR.0000072790.23090.41","article-title":"Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography","volume":"107","author":"Hachamovitch","year":"2003","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B35","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1093\/eurheartj\/ehq500","article-title":"Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. Medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy","volume":"32","author":"Hachamovitch","year":"2011","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B36","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s10554-021-02426-6","article-title":"Cardiac computed tomographic angiography after abnormal ischemia test as a gatekeeper to invasive coronary angiography","volume":"38","author":"Reis","year":"2022","journal-title":"Int J Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B37","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.jcmg.2016.10.025","article-title":"Prognostic value of coronary CT angiography with selective PET perfusion imaging in coronary artery disease","volume":"10","author":"Maaniitty","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B38","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.jcmg.2022.03.008","article-title":"Prognostic value of stress CMR in symptomatic patients with coronary stenosis on CCTA","volume":"15","author":"Pezel","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B39","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jcct.2021.08.001","article-title":"Prognostic value of myocardial perfusion imaging after first-line coronary computed tomography angiography: a multi-center cohort study","volume":"16","author":"Winther","year":"2022","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2026103011094883400_jeag259-B40","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1001\/2012.jama.11274","article-title":"Diagnostic accuracy of fractional flow reserve from anatomic CT angiography","volume":"308","author":"Min","year":"2012","journal-title":"JAMA"},{"key":"2026103011094883400_jeag259-B41","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jacc.2016.05.057","article-title":"1-year outcomes of FFRCT-guided care in patients with suspected coronary disease: the PLATFORM study","volume":"68","author":"Douglas","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B42","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.118.007607","article-title":"Impact of fractional flow reserve derived from coronary computed tomography angiography on heart team treatment decision-making in patients with multivessel coronary artery disease: insights from the SYNTAX III REVOLUTION trial","volume":"12","author":"Andreini","year":"2019","journal-title":"Circ Cardiovasc Interv"},{"key":"2026103011094883400_jeag259-B43","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jcmg.2019.03.003","article-title":"1-year impact on medical practice and clinical outcomes of FFRCT: the ADVANCE registry","volume":"13","author":"Patel","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B44","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1161\/CIRCULATIONAHA.114.011939","article-title":"Global coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity and modifies the effect of early revascularization","volume":"131","author":"Taqueti","year":"2015","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B45","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1007\/s12350-019-02000-7","article-title":"Prognostic value of coronary flow reserve in patients with suspected or known coronary artery disease referred to PET myocardial perfusion imaging: a meta-analysis","volume":"28","author":"Green","year":"2021","journal-title":"J Nucl Cardiol"},{"key":"2026103011094883400_jeag259-B46","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.2967\/jnumed.107.040758","article-title":"Added value of coronary artery calcium score as an adjunct to gated SPECT for the evaluation of coronary artery disease in an intermediate-risk population","volume":"48","author":"Schepis","year":"2007","journal-title":"J Nucl Med"},{"key":"2026103011094883400_jeag259-B47","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1161\/CIRCULATIONAHA.107.717512","article-title":"Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography\/computed tomography study","volume":"117","author":"Schenker","year":"2008","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B48","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1016\/j.jacc.2009.05.071","article-title":"The coronary artery calcium score and stress myocardial perfusion imaging provide independent and complementary prediction of cardiac risk","volume":"54","author":"Chang","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B49","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.ahj.2012.05.018","article-title":"Baseline stress myocardial perfusion imaging results and outcomes in patients with stable ischemic heart disease randomized to optimal medical therapy with or without percutaneous coronary intervention","volume":"164","author":"Shaw","year":"2012","journal-title":"Am Heart J"},{"key":"2026103011094883400_jeag259-B50","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jacc.2018.10.056","article-title":"Comparison of coronary computed tomography angiography, fractional flow reserve, and perfusion imaging for ischemia diagnosis","volume":"73","author":"Driessen","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B51","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/eurheartj\/ehz389","article-title":"Myocardial blood flow reserve assessed by positron emission tomography myocardial perfusion imaging identifies patients with a survival benefit from early revascularization","volume":"41","author":"Patel","year":"2020","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B52","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1093\/ehjci\/jez258","article-title":"Prognostic value of [15O]H2O positron emission tomography-derived global and regional myocardial perfusion","volume":"21","author":"Bom","year":"2020","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B53","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1161\/01.CIR.97.16.1557","article-title":"Noninvasive assessment of significant left anterior descending coronary artery stenosis by coronary flow velocity reserve with transthoracic color Doppler echocardiography","volume":"97","author":"Hozumi","year":"1998","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B54","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.amjcard.2008.10.033","article-title":"Additive prognostic value of coronary flow reserve in patients with chest pain syndrome and normal or near-normal coronary arteries","volume":"103","author":"Sicari","year":"2009","journal-title":"Am J Cardiol"},{"key":"2026103011094883400_jeag259-B55","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.ijcard.2016.11.004","article-title":"Transthoracic Doppler echocardiography compared with positron emission tomography for assessment of coronary microvascular dysfunction: the iPOWER study","volume":"228","author":"Michelsen","year":"2017","journal-title":"Int J Cardiol"},{"key":"2026103011094883400_jeag259-B56","first-page":"813","article-title":"Quantitative myocardial contrast echocardiography during pharmacological stress for diagnosis of coronary artery disease: a systematic review and meta-analysis of diagnostic accuracy studies","volume":"10","author":"Abdelmoneim","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2026103011094883400_jeag259-B57","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1056\/NEJMoa1100358","article-title":"Myocardial viability and survival in ischemic left ventricular dysfunction","volume":"364","author":"Bonow","year":"2011","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B58","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1056\/NEJMoa2206606","article-title":"Percutaneous revascularization for ischemic left ventricular dysfunction","volume":"387","author":"Perera","year":"2022","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B59","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1093\/eurheartj\/eht533","article-title":"Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients","volume":"35","author":"Rapsomaniki","year":"2014","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B60","article-title":"Assessing risk in patients with stable coronary disease: when should we intensify care and follow-up? Results from a meta-analysis of observational studies of the COURAGE and FAME era","volume":"2016","author":"Barbero","year":"2016","journal-title":"Scientifica (Cairo)"},{"key":"2026103011094883400_jeag259-B61","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/eurheartj\/ehz660","article-title":"Long-term outcomes of chronic coronary syndrome worldwide: insights from the international CLARIFY registry","volume":"41","author":"Sorbets","year":"2020","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B62","doi-asserted-by":"crossref","first-page":"2949","DOI":"10.1093\/eurheartj\/eht296","article-title":"2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology","volume":"34","author":"Task Force Members","year":"2013","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B63","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/j.jacc.2019.06.074","article-title":"Ischemia on PET MPI may identify patients with improvement in angina and health status post-revascularization","volume":"74","author":"Patel","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B64","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jacc.2022.04.052","article-title":"Benefit of early revascularization based on inducible ischemia and left ventricular ejection fraction","volume":"80","author":"Rozanski","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B65","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jcmg.2020.05.039","article-title":"Impact of early revascularization on major adverse cardiovascular events in relation to automatically quantified ischemia","volume":"14","author":"Azadani","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B66","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1007\/s12350-019-01932-4","article-title":"Survival benefit of coronary revascularization after myocardial perfusion SPECT: the role of ischemia","volume":"28","author":"Sharir","year":"2021","journal-title":"J Nucl Cardiol"},{"key":"2026103011094883400_jeag259-B67","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.jcmg.2013.10.021","article-title":"Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging","volume":"7","author":"Shaw","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B68","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1161\/CIRCULATIONAHA.120.049755","article-title":"Outcomes in the ISCHEMIA trial based on coronary artery disease and ischemia severity","volume":"144","author":"Reynolds","year":"2021","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B69","first-page":"e18","article-title":"2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B70","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1161\/CIR.0000000000000095","article-title":"2014 ACC\/AHA\/AATS\/PCNA\/SCAI\/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology\/American Heart Association task force on practice guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons","volume":"130","author":"Fihn","year":"2014","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B71","doi-asserted-by":"crossref","first-page":"821","DOI":"10.7326\/0003-4819-147-12-200712180-00001","article-title":"An externally validated model for predicting long-term survival after exercise treadmill testing in patients with suspected coronary artery disease and a normal electrocardiogram","volume":"147","author":"Lauer","year":"2007","journal-title":"Ann Intern Med"},{"key":"2026103011094883400_jeag259-B72","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jcmg.2008.11.015","article-title":"Prognostic value of coronary computed tomographic angiography for prediction of cardiac events in patients with suspected coronary artery disease","volume":"2","author":"Hadamitzky","year":"2009","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B73","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1001\/jamacardio.2019.0035","article-title":"Prognostic value of vasodilator stress cardiac magnetic resonance imaging: a multicenter study with 48 000 patient-years of follow-up","volume":"4","author":"Heitner","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2026103011094883400_jeag259-B74","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jcmg.2007.10.014","article-title":"A randomized cross-over study for evaluation of the effect of image optimization with contrast on the diagnostic accuracy of dobutamine echocardiography in coronary artery disease the OPTIMIZE trial","volume":"1","author":"Plana","year":"2008","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B75","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1093\/ehjci\/jeaa026","article-title":"Long-term prognostic value of stress myocardial perfusion echocardiography in patients with coronary artery disease: a meta-analysis","volume":"22","author":"Qian","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B76","doi-asserted-by":"crossref","first-page":"2446","DOI":"10.1016\/j.jacc.2013.04.019","article-title":"Patient outcome following 2 different stress imaging approaches: a prospective randomized comparison","volume":"61","author":"Porter","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B77","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.117.007483","article-title":"Clinical outcome of patients with inducible capillary blood flow abnormalities during demand stress in the presence or absence of angiographic coronary disease","volume":"11","author":"Kutty","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B78","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJMoa2208335","article-title":"Routine functional testing or standard care in high-risk patients after PCI","volume":"387","author":"Park","year":"2022","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B79","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1093\/eurheartj\/ehi102","article-title":"Impact of gender on risk stratification by exercise and dobutamine stress echocardiography: long-term mortality in 4234 women and 6898 men","volume":"26","author":"Shaw","year":"2005","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B80","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0140-6736(17)32714-9","article-title":"Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial","volume":"391","author":"Al-Lamee","year":"2018","journal-title":"Lancet"},{"key":"2026103011094883400_jeag259-B81","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.ijcard.2016.06.264","article-title":"A systematic review and meta-analysis of multidetector computed tomography in the assessment of coronary artery bypass grafts","volume":"221","author":"Chan","year":"2016","journal-title":"Int J Cardiol"},{"key":"2026103011094883400_jeag259-B82","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1007\/s00330-017-5256-3","article-title":"Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality","volume":"28","author":"Li","year":"2018","journal-title":"Eur Radiol"},{"key":"2026103011094883400_jeag259-B83","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jmir.2021.10.005","article-title":"The diagnostic accuracy of coronary computed tomography angiography in patients with and without previous coronary interventions","volume":"53","author":"Mansour","year":"2022","journal-title":"J Med Imaging Radiat Sci"},{"key":"2026103011094883400_jeag259-B84","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1148\/radiol.15141216","article-title":"Accuracy of CT for selecting candidates for coronary artery bypass graft surgery: combination with the SYNTAX score","volume":"276","author":"Suh","year":"2015","journal-title":"Radiology"},{"key":"2026103011094883400_jeag259-B85","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1016\/j.jacc.2011.08.047","article-title":"Prognostic assessment of coronary artery bypass patients with 64-slice computed tomography angiography: anatomical information is incremental to clinical risk prediction","volume":"58","author":"Small","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B86","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/0735-1097(96)00206-9","article-title":"Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years","volume":"28","author":"Fitzgibbon","year":"1996","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B87","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1007\/s11886-022-01746-w","article-title":"Diagnostic and management strategies in patients with late recurrent angina after coronary artery bypass grafting","volume":"24","author":"de Winter","year":"2022","journal-title":"Curr Cardiol Rep"},{"key":"2026103011094883400_jeag259-B88","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1001\/jamainternmed.2014.3773","article-title":"Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry","volume":"174","author":"Steg","year":"2014","journal-title":"JAMA Intern Med"},{"key":"2026103011094883400_jeag259-B89","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.echo.2019.03.001","article-title":"Coronary microvascular dysfunction by myocardial contrast echocardiography in nonelderly patients referred for computed tomographic coronary angiography","volume":"32","author":"Taqui","year":"2019","journal-title":"J Am Soc Echocardiogr"},{"key":"2026103011094883400_jeag259-B90","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijcard.2017.10.052","article-title":"The prognostic value of coronary endothelial and microvascular dysfunction in subjects with normal or non-obstructive coronary artery disease: a systematic review and meta-analysis","volume":"254","author":"Brainin","year":"2018","journal-title":"Int J Cardiol"},{"key":"2026103011094883400_jeag259-B91","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/eurheartj\/ehx721","article-title":"Coronary microvascular dysfunction and future risk of heart failure with preserved ejection fraction","volume":"39","author":"Taqueti","year":"2018","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B92","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1161\/CIRCULATIONAHA.116.023266","article-title":"Excess cardiovascular risk in women relative to men referred for coronary angiography is associated with severely impaired coronary flow reserve, not obstructive disease","volume":"135","author":"Taqueti","year":"2017","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B93","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1161\/CIRCULATIONAHA.116.024534","article-title":"Ischemia and no obstructive coronary artery disease (INOCA): developing evidence-based therapies and research agenda for the next decade","volume":"135","author":"Bairey Merz","year":"2017","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B94","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.jacc.2018.11.040","article-title":"Impact of abnormal coronary reactivity on long-term clinical outcomes in women","volume":"73","author":"AlBadri","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B95","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1016\/j.jcin.2018.07.052","article-title":"Intracoronary bolus injection versus intravenous infusion of adenosine for assessment of coronary flow velocity reserve in women with signs and symptoms of myocardial ischemia and no obstructive coronary artery disease","volume":"11","author":"AlBadri","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2026103011094883400_jeag259-B96","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jcin.2019.11.001","article-title":"1-year outcomes of angina management guided by invasive coronary function testing (CorMicA)","volume":"13","author":"Ford","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2026103011094883400_jeag259-B97","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-060602","article-title":"Management of ischaemia with non-obstructive coronary arteries (INOCA)","volume":"375","author":"Beltrame","year":"2021","journal-title":"BMJ"},{"key":"2026103011094883400_jeag259-B98","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1161\/01.CIR.67.5.995","article-title":"Diurnal distribution of ST-segment elevation and related arrhythmias in patients with variant angina: a study by ambulatory ECG monitoring","volume":"67","author":"Araki","year":"1983","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B99","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/0735-1097(95)00423-8","article-title":"Clinical observation of spontaneous anginal attacks and multivessel spasm in variant angina pectoris with normal coronary arteries: evaluation by 24-hour 12-lead electrocardiography with computer analysis","volume":"27","author":"Onaka","year":"1996","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B100","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s12471-019-1232-7","article-title":"Myocardial infarction with non-obstructive coronary arteries: a focus on vasospastic angina","volume":"27","author":"Beijk","year":"2019","journal-title":"Neth Heart J"},{"key":"2026103011094883400_jeag259-B101","first-page":"2565","article-title":"International standardization of diagnostic criteria for vasospastic angina","volume":"38","author":"Beltrame","year":"2017","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B102","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1001\/jama.2011.1652","article-title":"Association of coronary CT angiography or stress testing with subsequent utilization and spending among medicare beneficiaries","volume":"306","author":"Shreibati","year":"2011","journal-title":"JAMA"},{"key":"2026103011094883400_jeag259-B103","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/j.jcmg.2019.05.009","article-title":"Controversies in diagnostic imaging of patients with suspected stable and acute chest pain syndromes","volume":"12","author":"Shaw","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026103011094883400_jeag259-B104","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3390\/jcdd10010025","article-title":"The cost effectiveness of coronary CT angiography and the effective utilization of CT-fractional flow reserve in the diagnosis of coronary artery disease","volume":"10","author":"Burch","year":"2023","journal-title":"J Cardiovasc Dev Dis"},{"key":"2026103011094883400_jeag259-B105","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1056\/NEJMoa2200963","article-title":"CT or invasive coronary angiography in stable chest pain","volume":"386","author":"DISCHARGE Trial Group","year":"2022","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B106","doi-asserted-by":"crossref","first-page":"2777","DOI":"10.1093\/eurheartj\/ehag091","article-title":"Great debate: the new risk factor-weighted clinical likelihood model is useful to estimate the initial pre-test probability of obstructive coronary artery disease in individuals with suspected chronic coronary syndromes","volume":"47","author":"Andreotti","year":"2026","journal-title":"Eur Heart J"},{"key":"2026103011094883400_jeag259-B107","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1001\/jamacardio.2023.2595","article-title":"Comparison of an initial risk-based testing strategy vs usual testing in stable symptomatic patients with suspected coronary artery disease: the PRECISE randomized clinical trial","volume":"8","author":"Douglas","year":"2023","journal-title":"JAMA Cardiol"},{"key":"2026103011094883400_jeag259-B108","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1161\/CIRCULATIONAHA.123.063996","article-title":"On-site computed tomography-derived fractional flow reserve to guide management of patients with stable coronary artery disease: the TARGET randomized trial","volume":"147","author":"Yang","year":"2023","journal-title":"Circulation"},{"key":"2026103011094883400_jeag259-B109","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2023-002457","article-title":"External validation of novel clinical likelihood models to predict obstructive coronary artery disease and prognosis","volume":"10","author":"Rasmussen","year":"2023","journal-title":"Open Heart"},{"key":"2026103011094883400_jeag259-B110","article-title":"Comparison of the RF-CL and CACS-CL models to estimate the pretest probability of obstructive coronary artery disease and predict prognosis in patients with stable chest pain and diabetes mellitus","volume":"11","author":"Chen","year":"2024","journal-title":"Front Cardiovasc Med"},{"key":"2026103011094883400_jeag259-B111","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1016\/j.jacc.2022.08.805","article-title":"Coronary calcium scoring improves risk prediction in patients with suspected obstructive coronary artery disease","volume":"80","author":"Winther","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026103011094883400_jeag259-B112","article-title":"Angiography-derived physiology versus pressure wire-based fractional flow reserve for coronary revascularization guidance: a systematic review and meta-analysis","volume":"15","author":"Shah","year":"2026","journal-title":"JRSM Cardiovasc Dis"},{"key":"2026103011094883400_jeag259-B113","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJMoa2600949","article-title":"Angiography-derived fractional flow reserve to guide PCI","volume":"395","author":"Fearon","year":"2026","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B114","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1056\/NEJMoa2601841","article-title":"Angiography-based physiology to guide coronary revascularization","volume":"395","author":"Daemen","year":"2026","journal-title":"N Engl J Med"},{"key":"2026103011094883400_jeag259-B115","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1016\/S0140-6736(24)02175-5","article-title":"Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe): a multicentre, randomised, non-inferiority trial","volume":"404","author":"Andersen","year":"2024","journal-title":"Lancet"},{"key":"2026103011094883400_jeag259-B116","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinepi.2025.111968","article-title":"Living guidelines have come of age: new insights and methods-an open call for contributions","volume":"187","author":"Tunnicliffe","year":"2025","journal-title":"J Clin Epidemiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/advance-article-pdf\/doi\/10.1093\/ehjci\/jeag259\/71111177\/jeag259.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/27\/11\/1984\/71111177\/jeag259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/27\/11\/1984\/71111177\/jeag259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:10:07Z","timestamp":1793373007000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/27\/11\/1984\/8800194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":116,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,9,16]]},"published-print":{"date-parts":[[2026,10,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeag259","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,11]]},"published":{"date-parts":[[2026,9,16]]}}}