{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:30:18Z","timestamp":1793831418198,"version":"4.6.1"},"reference-count":150,"publisher":"Oxford University Press (OUP)","issue":"38","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The diagnosis of refractory angina has conventionally been limited to patients with angina and ischaemia secondary to obstructive atherosclerotic epicardial coronary disease who experience persistent symptoms despite optimal pharmacological and revascularization therapies. It is now well-established that angina may also be caused by ischaemia resulting from coronary microcirculatory disorders, coronary vasospasm, and bridging in the absence of obstructive epicardial coronary disease or after \u201csuccessful\u201d revascularization. This increasingly prevalent and symptomatic group of patients, with both angina and demonstrable ischaemia, have been excluded from the conventional definition of refractory angina. In patients with obstructive epicardial coronary disease, disturbed microcirculatory and vasomotor function, amongst other ischaemic mechanisms, may account for continuing symptoms despite revascularization. Under-recognition of these mechanisms results in inadequate treatment and symptom persistence. In this review, a redefinition of refractory angina is proposed to include the full spectrum of patients experiencing persistent angina despite current maximal guideline-directed medical and revascularization therapies. Systematic approaches for comprehensive investigation are suggested to identify underlying mechanisms of ischaemia and stratify treatments accordingly. The complex needs of patients with refractory angina are likely best addressed by an inter-disciplinary Angina Heart Team with the aim of improving patient symptoms, quality of life, and clinical outcomes.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehaf284","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:39:32Z","timestamp":1751359172000},"page":"3738-3757","source":"Crossref","is-referenced-by-count":16,"title":["Refractory angina: mechanisms and stratified treatment in obstructive and non-obstructive chronic myocardial ischaemic syndromes"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1107-2117","authenticated-orcid":false,"given":"Ranil","family":"de Silva","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Brompton Campus, Level 2 Chelsea Wing, Sydney Street, London SW3 6NP ,","place":["UK"]},{"name":"Specialist Angina Service, Royal Brompton and Harefield Hospitals part of Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Level 2 Chelsea Wing, Sydney Street, London SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1262-9474","authenticated-orcid":false,"given":"Kevin","family":"Cheng","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Brompton Campus, Level 2 Chelsea Wing, Sydney Street, London SW3 6NP ,","place":["UK"]},{"name":"Specialist Angina Service, Royal Brompton and Harefield Hospitals part of Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Level 2 Chelsea Wing, Sydney Street, London SW3 6NP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-0533","authenticated-orcid":false,"given":"Timothy D","family":"Henry","sequence":"additional","affiliation":[{"name":"The Carl and Edith Lindner Center of Research and Education, The Christ Hospital , 2123 Auburn Avenue, Suite 424, Cincinnati, OH 45219 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6362-1291","authenticated-orcid":false,"given":"Divaka","family":"Perera","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre of Research Excellence at the School of Cardiovascular and Metabolic Medicine & Sciences, King's College London , Westminster Bridge Road, London SE1 7EH ,","place":["UK"]},{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust , Westminster Bridge Road, London SE1 7EH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0136-3781","authenticated-orcid":false,"given":"Viviany R","family":"Taqueti","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Program, Departments of Radiology and Medicine, Brigham and Women's Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0786-7830","authenticated-orcid":false,"given":"Ana","family":"Abreu","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation Centre, Department of Cardiology, ULS Santa Maria and Faculdade Medicina de Universidade Lisboa (CAML), ISAMB, IMPSP, CCUL, Av. Professor Egas Moniz, 1649-028, Lisboa ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6693-7355","authenticated-orcid":false,"given":"Fabienne","family":"Vervaat","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Catharina Hospital , Michelangelolaan 2, Eindhoven 5623 EJ ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0735-9756","authenticated-orcid":false,"given":"Martha","family":"Gulati","sequence":"additional","affiliation":[{"name":"Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center , 8700 Beverly Blvd., Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7534-4826","authenticated-orcid":false,"given":"Hiroaki","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"Graduate School, International University of Health and Welfare , Kozunomori 4-3, Narita 286-8686 ,","place":["Japan"]},{"name":"Department of Cardiovascular Medicine, Tohoku University , Seiryo-machi 1-1, Sendai 980-8574 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1456-6430","authenticated-orcid":false,"given":"Felicita","family":"Andreotti","sequence":"additional","affiliation":[{"name":"Cardiovascular Science Department, Fondazione Policlinico Universitario A. Gemelli IRCCS , Largo Gemelli 8, 00168 Rome ,","place":["Italy"]},{"name":"CardioThoracic Department, Catholic University Medical School , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8068-0189","authenticated-orcid":false,"given":"Juan-Carlos","family":"Kaski","sequence":"additional","affiliation":[{"name":"Molecular and Clinical Sciences Research Institute, St. George's University of London , Cranmer Terrace, London SW17 0RE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025100619514109800_ehaf284-B1","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1053\/euhj.2001.2706","article-title":"The problem of chronic refractory angina; report from the ESC Joint Study Group on the treatment of refractory angina","volume":"23","author":"Mannheimer","year":"2002","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B2","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1161\/CIRCULATIONAHA.118.031373","article-title":"Reappraisal of ischemic heart disease","volume":"138","author":"Kaski","year":"2018","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B3","doi-asserted-by":"publisher","first-page":"e009002","DOI":"10.1161\/CIRCINTERVENTIONS.120.009002","article-title":"Therapeutic approaches for the no-option refractory angina patient","volume":"14","author":"Povsic","year":"2021","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B4","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijcard.2022.09.047","article-title":"Ischemia with no obstructive coronary artery disease (INOCA): a patient self-report quality of life survey from INOCA international","volume":"371","author":"Gulati","year":"2023","journal-title":"Int J Cardiol"},{"key":"2025100619514109800_ehaf284-B5","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1056\/NEJMra061889","article-title":"Coronary microvascular dysfunction","volume":"356","author":"Camici","year":"2007","journal-title":"N Engl J Med"},{"key":"2025100619514109800_ehaf284-B6","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.1016\/j.cjca.2011.10.015","article-title":"Patients with coronary artery disease unsuitable for revascularization: definition, general principles, and a classification","volume":"28","author":"Jolicoeur","year":"2012","journal-title":"Can J Cardiol"},{"key":"2025100619514109800_ehaf284-B7","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/S0140-6736(21)02045-6","article-title":"What constitutes an appropriate empirical trial of antianginal therapy in patients with stable angina before referral for revascularisation?","volume":"399","author":"Boden","year":"2022","journal-title":"Lancet"},{"key":"2025100619514109800_ehaf284-B8","doi-asserted-by":"publisher","first-page":"S20","DOI":"10.1016\/j.cjca.2011.07.007","article-title":"Management of patients with refractory angina: Canadian Cardiovascular Society\/Canadian Pain Society joint guidelines","volume":"28","author":"McGillion","year":"2012","journal-title":"Can J Cardiol"},{"key":"2025100619514109800_ehaf284-B9","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1093\/eurheartj\/eht165","article-title":"Long-term survival in patients with refractory angina","volume":"34","author":"Henry","year":"2013","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B10","doi-asserted-by":"publisher","first-page":"2319","DOI":"10.1056\/NEJMoa2310610","article-title":"A placebo-controlled trial of percutaneous coronary intervention for stable angina","volume":"389","author":"Rajkumar","year":"2023","journal-title":"N Engl J Med"},{"key":"2025100619514109800_ehaf284-B11","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1161\/CIRCULATIONAHA.107.726562","article-title":"Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology-National Cardiovascular Data Registry","volume":"117","author":"Shaw","year":"2008","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B12","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.jcin.2023.11.039","article-title":"Coronary vasomotor dysfunction is associated with cardiovascular events in patients with nonobstructive coronary artery disease","volume":"17","author":"Kanaji","year":"2024","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B13","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.1093\/eurheartj\/ehab775","article-title":"Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis","volume":"43","author":"Kelshiker","year":"2022","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B14","doi-asserted-by":"publisher","first-page":"4592","DOI":"10.1093\/eurheartj\/ehab282","article-title":"Clinical characteristics and prognosis of patients with microvascular angina\u2014an international and prospective cohort study by the Coronary Vasomotion Disorders International Study (COVADIS) Group","volume":"42","author":"Shimokawa","year":"2021","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/clc.22599","article-title":"A prospective study of patients with refractory angina: outcomes and the role of high-sensitivity troponin T","volume":"40","author":"Poppi","year":"2017","journal-title":"Clin Cardiol"},{"key":"2025100619514109800_ehaf284-B16","doi-asserted-by":"publisher","first-page":"e013168","DOI":"10.1161\/JAHA.119.013168","article-title":"Angina hospitalization rates in women with signs and symptoms of ischemia but no obstructive coronary artery disease: a report from the WISE (Women's Ischemia Syndrome Evaluation)","volume":"9","author":"Aldiwani","year":"2020","journal-title":"Study. J Am Heart Assoc"},{"key":"2025100619514109800_ehaf284-B17","doi-asserted-by":"publisher","first-page":"e93170","DOI":"10.1371\/journal.pone.0093170","article-title":"Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study","volume":"9","author":"Jespersen","year":"2014","journal-title":"PLoS One"},{"key":"2025100619514109800_ehaf284-B18","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1161\/CIRCULATIONAHA.105.609990","article-title":"The economic burden of angina in women with suspected ischemic heart disease: results from the National Institutes of Health\u2013National Heart, Lung, and Blood Institute\u2013sponsored Women's Ischemia Syndrome Evaluation","volume":"114","author":"Shaw","year":"2006","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B19","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1016\/j.jcin.2020.05.009","article-title":"Long-term follow-up in patients with stable angina and unobstructed coronary arteries undergoing intracoronary acetylcholine testing","volume":"13","author":"Seitz","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B20","doi-asserted-by":"publisher","first-page":"e001287","DOI":"10.1161\/JAHA.114.001287","article-title":"Predictors of long-term clinical endpoints in patients with refractory angina","volume":"4","author":"Povsic","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2025100619514109800_ehaf284-B21","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1016\/j.jcmg.2021.01.041","article-title":"Functional and economic impact of INOCA and influence of coronary microvascular dysfunction","volume":"14","author":"Schumann","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B22","doi-asserted-by":"publisher","first-page":"4601","DOI":"10.1093\/eurheartj\/ehab534","article-title":"Microvascular angina: quo tendimus?","volume":"42","author":"de Silva","year":"2021","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B23","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1161\/CIRCULATIONAHA.108.834739","article-title":"Assessment of microcirculatory remodeling with intracoronary flow velocity and pressure measurements: validation with endomyocardial sampling in cardiac allografts","volume":"120","author":"Escaned","year":"2009","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B24","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1097\/HJH.0000000000000338","article-title":"The blunting of coronary flow reserve in hypertension with left ventricular hypertrophy is transmural and correlates with systolic blood pressure","volume":"32","author":"Rimoldi","year":"2014","journal-title":"J Hypertens"},{"key":"2025100619514109800_ehaf284-B25","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1093\/eurheartj\/ehy857","article-title":"Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization","volume":"40","author":"Crea","year":"2019","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B26","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.jacc.2022.08.814","article-title":"Evolving management paradigm for stable ischemic heart disease patients","volume":"81","author":"Boden","year":"2023","journal-title":"JACC Review Topic of the Week. J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B27","doi-asserted-by":"publisher","first-page":"e012511","DOI":"10.1161\/CIRCINTERVENTIONS.122.012511","article-title":"Angina after percutaneous coronary intervention: patient and procedural predictors","volume":"16","author":"Collison","year":"2023","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B28","doi-asserted-by":"publisher","first-page":"3504","DOI":"10.1093\/eurheartj\/ehaa503","article-title":"An EAPCI expert consensus document on ischaemia with non-obstructive coronary arteries in collaboration with European society of cardiology working group on coronary pathophysiology & microcirculation endorsed by coronary vasomotor disorders international study group","volume":"41","author":"Kunadian","year":"2020","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B29","doi-asserted-by":"publisher","first-page":"5836","DOI":"10.3390\/jcm12185836","article-title":"Symptom presentation among women with suspected Ischemia and No Obstructive Coronary Artery Disease (INOCA)","volume":"12","author":"Taha","year":"2023","journal-title":"J Clin Med"},{"key":"2025100619514109800_ehaf284-B30","doi-asserted-by":"publisher","first-page":"2565","DOI":"10.1093\/eurheartj\/ehv351","article-title":"International standardization of diagnostic criteria for vasospastic angina","volume":"38","author":"Beltrame","year":"2017","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B31","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/j.jacc.2004.12.084","article-title":"Insights from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study: part II: gender differences in presentation, diagnosis, and outcome with regard to gender-based pathophysiology of atherosclerosis and macrovascular and microvascular coronary disease","volume":"47","author":"Bairey Merz","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B32","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1089\/jwh.2012.4031","article-title":"Anginal symptoms, coronary artery disease, and adverse outcomes in black and white women: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study","volume":"22","author":"Eastwood","year":"2013","journal-title":"J Womens Health (Larchmt)"},{"key":"2025100619514109800_ehaf284-B33","doi-asserted-by":"publisher","first-page":"5646","DOI":"10.3390\/jcm12175646","article-title":"Sex differences in quality of life in patients with Ischemia with No Obstructive Coronary Artery Disease (INOCA): a patient self-report retrospective survey from INOCA international","volume":"12","author":"Ranasinghe","year":"2023","journal-title":"J Clin Med"},{"key":"2025100619514109800_ehaf284-B34","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ijcard.2019.02.038","article-title":"Clinical characteristics and long-term prognosis of contemporary patients with vasospastic angina: ethnic differences detected in an international comparative study","volume":"291","author":"Sato","year":"2019","journal-title":"Int J Cardiol"},{"key":"2025100619514109800_ehaf284-B35","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1136\/heartjnl-2016-310905","article-title":"Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses","volume":"103","author":"Hoorweg","year":"2017","journal-title":"Heart"},{"key":"2025100619514109800_ehaf284-B36","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf079","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes: developed by the task force for the management of chronic coronary syndromes of the European Society of Cardiology (ESC) endorsed by the European association for cardio-thoracic surgery (EACTS)","volume":"45","author":"Vrints","year":"2025","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B37","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.jcin.2012.01.023","article-title":"Safety of coronary reactivity testing in women with no obstructive coronary artery disease: results from the NHLBI-sponsored WISE (Women's Ischemia Syndrome Evaluation) study","volume":"5","author":"Wei","year":"2012","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B38","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1161\/CIRCULATIONAHA.113.004096","article-title":"Clinical usefulness, angiographic characteristics, and safety evaluation of intracoronary acetylcholine provocation testing among 921 consecutive white patients with unobstructed coronary arteries","volume":"129","author":"Ong","year":"2014","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B39","doi-asserted-by":"publisher","first-page":"2590","DOI":"10.1093\/eurheartj\/ehaa857","article-title":"Assessment and pathophysiology of microvascular disease: recent progress and clinical implications","volume":"42","author":"Masi","year":"2021","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B40","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1016\/j.jacc.2022.03.385","article-title":"Safety of provocative testing with intracoronary acetylcholine and implications for standard protocols","volume":"79","author":"Takahashi","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B41","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1136\/heartjnl-2021-320718","article-title":"Invasive coronary physiology in patients with angina and non-obstructive coronary artery disease: a consensus document from the coronary microvascular dysfunction workstream of the British Heart Foundation\/National Institute for Health Research Partnership","volume":"109","author":"Perera","year":"2022","journal-title":"Heart"},{"key":"2025100619514109800_ehaf284-B42","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1093\/eurheartj\/ehab548","article-title":"Invasive and non-invasive assessment of ischaemia in chronic coronary syndromes: translating pathophysiology to clinical practice","volume":"43","author":"Demir","year":"2022","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B43","doi-asserted-by":"publisher","first-page":"e013657","DOI":"10.1161\/CIRCINTERVENTIONS.123.013657","article-title":"Characterizing mechanisms of ischemia in patients with myocardial bridges","volume":"17","author":"Sinha","year":"2024","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B44","doi-asserted-by":"publisher","first-page":"102196","DOI":"10.1016\/j.jscai.2024.102196","article-title":"Prevalence of coronary microvascular dysfunction and epicardial spasm in patients with angina and myocardial bridge","volume":"3","author":"Allan","year":"2024","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"2025100619514109800_ehaf284-B45","doi-asserted-by":"publisher","first-page":"102244","DOI":"10.1016\/j.jscai.2024.102244","article-title":"When is it a bridge too far?","volume":"3","author":"Tzoumas","year":"2024","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"2025100619514109800_ehaf284-B46","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1016\/j.jacc.2021.09.859","article-title":"Myocardial bridging: diagnosis, functional assessment, and management: JACC state-of-the-art review","volume":"78","author":"Sternheim","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B47","doi-asserted-by":"publisher","first-page":"e368","DOI":"10.1161\/CIR.0000000000001029","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":"2025100619514109800_ehaf284-B48","doi-asserted-by":"publisher","first-page":"e123","DOI":"10.4244\/EIJ-D-23-00448","article-title":"Coronary spasm and vasomotor dysfunction as a cause of MINOCA","volume":"20","author":"Yaker","year":"2024","journal-title":"EuroIntervention"},{"key":"2025100619514109800_ehaf284-B49","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1016\/j.jacc.2023.06.043","article-title":"Comprehensive management of ANOCA, part 1-definition, patient population, and diagnosis: JACC state-of-the-art review","volume":"82","author":"Samuels","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B50","doi-asserted-by":"publisher","first-page":"2841","DOI":"10.1016\/j.jacc.2018.09.006","article-title":"Stratified medical therapy using invasive coronary function testing in angina: the CorMicA trial","volume":"72","author":"Ford","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B51","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1016\/j.jacc.2019.08.1056","article-title":"Coronary functional abnormalities in patients with angina and nonobstructive coronary artery disease","volume":"74","author":"Suda","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B52","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1016\/j.jcmg.2022.03.012","article-title":"Efficacy of diltiazem to improve coronary vasomotor dysfunction in ANOCA: the EDIT-CMD randomized clinical trial","volume":"15","author":"Jansen","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B53","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1016\/j.jcin.2018.05.021","article-title":"Coronary psychology: do you believe?","volume":"11","author":"Johnson","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B54","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1016\/j.jcin.2020.04.040","article-title":"The impact of coronary physiology on contemporary clinical decision making","volume":"13","author":"Kogame","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B55","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1016\/j.jacc.2022.09.007","article-title":"2-Year outcomes of angiographic quantitative flow ratio-guided coronary interventions","volume":"80","author":"Song","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B56","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1038\/s41569-020-0341-8","article-title":"Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia","volume":"17","author":"Dewey","year":"2020","journal-title":"Nat Rev Cardiol"},{"key":"2025100619514109800_ehaf284-B57","doi-asserted-by":"publisher","first-page":"e009019","DOI":"10.1161\/CIRCINTERVENTIONS.120.009019","article-title":"Optimal use of vasodilators for diagnosis of microvascular angina in the Cardiac Catheterization Laboratory","volume":"13","author":"Rahman","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B58","doi-asserted-by":"publisher","first-page":"2625","DOI":"10.1016\/j.jacc.2018.09.042","article-title":"Coronary microvascular disease pathogenic mechanisms and therapeutic options: JACC state-of-the-art review","volume":"72","author":"Taqueti","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B59","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1016\/j.jcmg.2018.12.022","article-title":"Automated pixel-wise quantitative myocardial perfusion mapping by CMR to detect obstructive coronary artery disease and coronary microvascular dysfunction: validation against invasive coronary physiology","volume":"12","author":"Kotecha","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B60","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1093\/eurheartj\/ehx178","article-title":"Apheresis as novel treatment for refractory angina with raised lipoprotein(a): a randomized controlled cross-over trial","volume":"38","author":"Khan","year":"2017","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B61","doi-asserted-by":"publisher","first-page":"e016138","DOI":"10.1161\/CIRCIMAGING.123.016138","article-title":"Impact of absolute myocardial blood flow quantification on the diagnostic performance of PET-based perfusion scans using 82Rubidium","volume":"17","author":"Rasmussen","year":"2024","journal-title":"Circ Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B62","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s12350-022-02948-z","article-title":"Non-invasive diagnosis of vasospastic angina","volume":"30","author":"Ngo","year":"2023","journal-title":"J Nucl Cardiol"},{"key":"2025100619514109800_ehaf284-B63","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1093\/cvr\/28.11.1595","article-title":"Role of positron emission tomography in the investigation of human coronary circulatory function","volume":"28","author":"de Silva","year":"1994","journal-title":"Cardiovasc Res"},{"key":"2025100619514109800_ehaf284-B64","doi-asserted-by":"publisher","first-page":"273","DOI":"10.2967\/jnumed.117.201368","article-title":"Clinical quantification of myocardial blood flow using PET: joint position paper of the SNMMI cardiovascular council and the ASNC","volume":"59","author":"Murthy","year":"2018","journal-title":"J Nucl Med"},{"key":"2025100619514109800_ehaf284-B65","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1016\/j.jcmg.2019.03.035","article-title":"Positron-emission tomography quantitative measurements of myocardial blood flow: just the facts\u2026","volume":"12","author":"Gewirtz","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B66","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1016\/j.jcmg.2022.12.015","article-title":"Myocardial perfusion PET for the detection and reporting of coronary microvascular dysfunction: a JACC: cardiovascular imaging expert panel statement","volume":"16","author":"Schindler","year":"2023","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B67","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/j.jacc.2018.05.049","article-title":"Coronary microvascular dysfunction and cardiovascular risk in obese patients","volume":"72","author":"Bajaj","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B68","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B69","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B70","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1161\/CIRCULATIONAHA.114.009716","article-title":"Interaction of impaired coronary flow reserve and cardiomyocyte injury on adverse cardiovascular outcomes in patients without overt coronary artery disease","volume":"131","author":"Taqueti","year":"2015","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B71","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B72","doi-asserted-by":"publisher","first-page":"2642","DOI":"10.1016\/j.jacc.2018.07.106","article-title":"Coronary physiology beyond coronary flow reserve in microvascular angina: JACC state-of-the-art review","volume":"72","author":"Gould","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B73","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1093\/eurheartj\/ehad579","article-title":"Coronary flow capacity and survival prediction after revascularization: physiological basis and clinical implications","volume":"45","author":"Gould","year":"2024","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B74","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1093\/eurheartj\/ehad812","article-title":"Leveraging global coronary flow assessments to inform revascularization benefit in chronic coronary disease: time to test total heart flow","volume":"45","author":"Taqueti","year":"2024","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B75","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1016\/j.jcin.2018.07.011","article-title":"Doppler flow velocity and thermodilution to assess coronary flow reserve: a head-to-head comparison with [15O]H2O PET","volume":"11","author":"Everaars","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B76","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1093\/eurheartj\/ehz245","article-title":"Continuous thermodilution to assess absolute flow and microvascular resistance: validation in humans using [15O]H2O positron emission tomography","volume":"40","author":"Everaars","year":"2019","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B77","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B78","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12968-017-0355-5","article-title":"Myocardial perfusion cardiovascular magnetic resonance: optimized dual sequence and reconstruction for quantification","volume":"19","author":"Kellman","year":"2017","journal-title":"J Cardiovasc Magn Reson"},{"key":"2025100619514109800_ehaf284-B79","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1093\/ehjci\/jeae084","article-title":"High-resolution free-breathing automated quantitative myocardial perfusion by cardiovascular magnetic resonance for the detection of functionally significant coronary artery disease","volume":"25","author":"Crawley","year":"2024","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B80","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1016\/j.jcmg.2020.10.015","article-title":"High-resolution cardiac magnetic resonance imaging techniques for the identification of coronary microvascular dysfunction","volume":"14","author":"Rahman","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B81","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B82","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1016\/S0735-1097(99)00342-3","article-title":"Validation of a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary flow reserve: comparison with intracoronary Doppler flow wire","volume":"34","author":"Caiati","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B83","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/eurheartj\/ehaa944","article-title":"Coronary flow velocity reserve predicts adverse prognosis in women with angina and no obstructive coronary artery disease: results from the iPOWER study","volume":"42","author":"Schroder","year":"2021","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B84","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1093\/ehjci\/jex182","article-title":"Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017","volume":"18","author":"Senior","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025100619514109800_ehaf284-B85","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1038\/s41551-024-01206-6","article-title":"Transthoracic ultrasound localization microscopy of myocardial vasculature in patients","volume":"8","author":"Yan","year":"2024","journal-title":"Nat Biomed Eng"},{"key":"2025100619514109800_ehaf284-B86","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1038\/nrcardio.2017.131","article-title":"Expert consensus document: a \u2018diamond\u2019 approach to personalized treatment of angina","volume":"15","author":"Ferrari","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"2025100619514109800_ehaf284-B87","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1161\/01.CIR.81.4.1260","article-title":"Efficacy and safety of perhexiline maleate in refractory angina. A double-blind placebo-controlled clinical trial of a novel antianginal agent","volume":"81","author":"Cole","year":"1990","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B88","doi-asserted-by":"publisher","first-page":"e24158","DOI":"10.1002\/clc.24158","article-title":"Antianginal effects of empagliflozin in patients with type 2 diabetes and refractory angina; a randomized, double-blind placebo-controlled trial (EMPT-ANGINA Trial)","volume":"47","author":"Mansouri","year":"2024","journal-title":"Clin Cardiol"},{"key":"2025100619514109800_ehaf284-B89","doi-asserted-by":"publisher","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":"2025100619514109800_ehaf284-B90","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1161\/CIRCULATIONAHA.123.066680","article-title":"ChaMP-CMD: a phenotype-blinded, randomized controlled, cross-over trial","volume":"149","author":"Sinha","year":"2024","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B91","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/BF01616842","article-title":"The effect of trimetazidine in the treatment of microvascular angina","volume":"8","author":"Nalbantgil","year":"1999","journal-title":"Int J Angiol"},{"key":"2025100619514109800_ehaf284-B92","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1161\/CIRCULATIONAHA.124.069901","article-title":"Zibotentan in microvascular angina: a randomized, placebo-controlled, crossover trial","volume":"150","author":"Morrow","year":"2024","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B93","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1161\/CIRCULATIONAHA.111.037283","article-title":"Mechanisms of coronary artery spasm","volume":"124","author":"Lanza","year":"2011","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B94","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.15420\/ecr.2022.47","article-title":"Management of coronary artery spasm","volume":"18","author":"Lanza","year":"2023","journal-title":"Eur Cardiol"},{"key":"2025100619514109800_ehaf284-B95","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1093\/eurheartj\/ehw256","article-title":"Beneficial effects of long-acting nifedipine on coronary vasomotion abnormalities after drug-eluting stent implantation: the NOVEL study","volume":"37","author":"Tsuburaya","year":"2016","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B96","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/eurheartj\/ehu313","article-title":"Prognostic impact of chronic nitrate therapy in patients with vasospastic angina: multicentre registry study of the Japanese coronary spasm association","volume":"36","author":"Takahashi","year":"2015","journal-title":"Eur Heart J"},{"key":"2025100619514109800_ehaf284-B97","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/S0735-1097(02)02632-3","article-title":"Rho-kinase inhibition with intracoronary fasudil prevents myocardial ischemia in patients with coronary microvascular spasm","volume":"41","author":"Mohri","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B98","doi-asserted-by":"publisher","first-page":"1156456","DOI":"10.3389\/fcvm.2023.1156456","article-title":"Drug repurposing-a promising approach for patients with angina but non-obstructive coronary artery disease (ANOCA)","volume":"10","author":"McChord","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"2025100619514109800_ehaf284-B99","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1056\/NEJMoa1402556","article-title":"Efficacy of a device to narrow the coronary sinus in refractory angina","volume":"372","author":"Verheye","year":"2015","journal-title":"N Engl J Med"},{"key":"2025100619514109800_ehaf284-B100","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.ijcard.2021.05.034","article-title":"Safety and efficacy of coronary sinus narrowing in chronic refractory angina: insights from the RESOURCE study","volume":"337","author":"Ponticelli","year":"2021","journal-title":"Int J Cardiol"},{"key":"2025100619514109800_ehaf284-B101","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.cjca.2021.12.009","article-title":"Effectiveness of coronary sinus reducer for treatment of refractory angina: a meta-analysis","volume":"38","author":"Hochstadt","year":"2022","journal-title":"Can J Cardiol"},{"key":"2025100619514109800_ehaf284-B102","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1016\/S0140-6736(24)00256-3","article-title":"Coronary sinus reducer for the treatment of refractory angina (ORBITA-COSMIC): a randomised, placebo-controlled trial","volume":"403","author":"Foley","year":"2024","journal-title":"Lancet"},{"key":"2025100619514109800_ehaf284-B103","doi-asserted-by":"crossref","first-page":"2908","DOI":"10.1016\/j.jcin.2024.08.047","article-title":"Coronary sinus narrowing for treating refractory angina: REDUCER-I multicenter \u201cReal-World\u201d observational study primary endpoint analysis","volume":"17","author":"Verheye","year":"2024","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B104","doi-asserted-by":"publisher","first-page":"101803","DOI":"10.1016\/j.nuclcard.2024.101803","article-title":"Redistribution of myocardial perfusion after coronary sinus reducer implantation demonstrated by rubidium-82 positron emission tomography","volume":"33","author":"Cheng","year":"2024","journal-title":"J Nucl Cardiol"},{"key":"2025100619514109800_ehaf284-B105","doi-asserted-by":"publisher","first-page":"e013481","DOI":"10.1161\/CIRCINTERVENTIONS.123.013481","article-title":"Coronary sinus narrowing improves coronary microcirculation function in patients with refractory angina: a multicenter prospective INROAD study","volume":"17","author":"Tebaldi","year":"2024","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B106","doi-asserted-by":"publisher","first-page":"e9","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":"2025100619514109800_ehaf284-B107","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1136\/hrt.2009.184507","article-title":"Coronary collateral growth by external counterpulsation: a randomised controlled trial","volume":"96","author":"Gloekler","year":"2010","journal-title":"Heart"},{"key":"2025100619514109800_ehaf284-B108","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1161\/CIRCULATIONAHA.109.923482","article-title":"Enhanced external counterpulsation improves peripheral artery flow-mediated dilation in patients with chronic angina: a randomized sham-controlled study","volume":"122","author":"Braith","year":"2010","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B109","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1016\/S0735-1097(99)00140-0","article-title":"The multicenter study of enhanced external counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and anginal episodes","volume":"33","author":"Arora","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B110","doi-asserted-by":"publisher","first-page":"CD007219","DOI":"10.1002\/14651858.CD007219.pub2","article-title":"Enhanced external counterpulsation for chronic angina pectoris","volume":"2010","author":"Amin","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"2025100619514109800_ehaf284-B111","doi-asserted-by":"publisher","first-page":"iii","DOI":"10.3310\/hta13240","article-title":"Enhanced external counterpulsation for the treatment of stable angina and heart failure: a systematic review and economic analysis","volume":"13","author":"McKenna","year":"2009","journal-title":"Health Technol Assess"},{"key":"2025100619514109800_ehaf284-B112","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.amjcard.2023.10.061","article-title":"Enhanced external counterpulsation for the treatment of angina with nonobstructive coronary artery disease","volume":"211","author":"Ashokprabhu","year":"2024","journal-title":"Am J Cardiol"},{"key":"2025100619514109800_ehaf284-B113","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.1161\/CIRCRESAHA.118.314118","article-title":"The impact of cell therapy on cardiovascular outcomes in patients with refractory angina","volume":"124","author":"Jones","year":"2019","journal-title":"Circ Res"},{"key":"2025100619514109800_ehaf284-B114","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jcin.2019.08.055","article-title":"Refractory angina: from pathophysiology to new therapeutic nonpharmacological technologies","volume":"13","author":"Gallone","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B115","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.carrev.2018.05.018","article-title":"Intramyocardial autologous CD34 + cell therapy for refractory angina: a meta-analysis of randomized controlled trials","volume":"20","author":"Velagapudi","year":"2019","journal-title":"Cardiovasc Revasc Med"},{"key":"2025100619514109800_ehaf284-B116","doi-asserted-by":"publisher","first-page":"e010802","DOI":"10.1161\/CIRCINTERVENTIONS.121.010802","article-title":"Autologous CD34+ stem cell therapy increases coronary flow reserve and reduces angina in patients with coronary microvascular dysfunction","volume":"15","author":"Henry","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B117","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1161\/CIRCRESAHA.121.319644","article-title":"IMPROvE-CED trial: intracoronary autologous CD34+ cell therapy for treatment of coronary endothelial dysfunction in patients with angina and nonobstructive coronary arteries","volume":"130","author":"Corban","year":"2022","journal-title":"Circ Res"},{"key":"2025100619514109800_ehaf284-B118","doi-asserted-by":"publisher","first-page":"e014054","DOI":"10.1161\/CIRCINTERVENTIONS.124.014054","article-title":"Angiogenic gene therapy for refractory angina: results of the EXACT phase 2 trial","volume":"17","author":"Nakamura","year":"2024","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B119","doi-asserted-by":"publisher","first-page":"3055","DOI":"10.1161\/01.CIR.0000148849.51177.97","article-title":"Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo","volume":"110","author":"Nishida","year":"2004","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B120","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1111\/echo.14054","article-title":"Cardiac shock wave therapy improves myocardial perfusion and preserves left ventricular mechanics in patients with refractory angina: a study with speckle tracking echocardiography","volume":"35","author":"Duque","year":"2018","journal-title":"Echocardiography"},{"key":"2025100619514109800_ehaf284-B121","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.echo.2019.04.420","article-title":"Shock-wave therapy improves myocardial blood flow reserve in patients with refractory angina: evaluation by real-time myocardial perfusion echocardiography","volume":"32","author":"Ceccon","year":"2019","journal-title":"J Am Soc Echocardiogr"},{"key":"2025100619514109800_ehaf284-B122","doi-asserted-by":"publisher","first-page":"e104863","DOI":"10.1371\/journal.pone.0104863","article-title":"Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia","volume":"9","author":"Hanawa","year":"2014","journal-title":"PLoS One"},{"key":"2025100619514109800_ehaf284-B123","doi-asserted-by":"publisher","first-page":"e0287714","DOI":"10.1371\/journal.pone.0287714","article-title":"A randomized, double-blind, placebo-controlled pilot trial of low-intensity pulsed ultrasound therapy for refractory angina pectoris","volume":"18","author":"Shindo","year":"2023","journal-title":"PLoS One"},{"key":"2025100619514109800_ehaf284-B124","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1002\/ccd.21358","article-title":"Outcome of intracoronary stenting after failed maximal medical therapy in patients with symptomatic myocardial bridge","volume":"71","author":"Kunamneni","year":"2008","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B125","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1111\/jocs.12101","article-title":"Results of coronary artery bypass grafting in myocardial bridging of left anterior descending artery","volume":"28","author":"Bockeria","year":"2013","journal-title":"J Card Surg"},{"key":"2025100619514109800_ehaf284-B126","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.athoracsur.2019.07.005","article-title":"Clinical outcomes of surgical unroofing of myocardial bridging in symptomatic patients","volume":"109","author":"Hemmati","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2025100619514109800_ehaf284-B127","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/S0140-6736(94)92755-3","article-title":"Central nervous pathways mediating angina pectoris","volume":"344","author":"Rosen","year":"1994","journal-title":"Lancet"},{"key":"2025100619514109800_ehaf284-B128","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1136\/heart.87.6.513","article-title":"Central neural contribution to the perception of chest pain in cardiac syndrome X","volume":"87","author":"Rosen","year":"2002","journal-title":"Heart"},{"key":"2025100619514109800_ehaf284-B129","doi-asserted-by":"publisher","DOI":"10.1093\/ehjopen\/oeac083","article-title":"Neuromodulation in patients with refractory angina pectoris: a review","volume":"3","author":"Vervaat","year":"2023","journal-title":"Eur Heart J Open"},{"key":"2025100619514109800_ehaf284-B130","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1038\/nrcardio.2013.200","article-title":"Treatment of refractory angina in patients not suitable for revascularization","volume":"11","author":"Henry","year":"2014","journal-title":"Nat Rev Cardiol"},{"key":"2025100619514109800_ehaf284-B131","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1097\/ALN.0b013e3181c43103","article-title":"Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine","volume":"112","author":"American Society of Anesthesiologists Task Force on Chronic Pain Management","year":"2010","journal-title":"Anesthesiology"},{"key":"2025100619514109800_ehaf284-B132","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1002\/clc.24016","article-title":"Design and rationale of the efficacy of spinal cord stimulation in patients with refractory angina pectoris (SCRAP) trial","volume":"46","author":"Vervaat","year":"2023","journal-title":"Clin Cardiol"},{"key":"2025100619514109800_ehaf284-B133","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/j.rec.2022.04.003","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice: developed by the task force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC)","volume":"75","author":"Visseren","year":"2022","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2025100619514109800_ehaf284-B134","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1161\/01.CIR.94.3.258","article-title":"Angiotensin-converting enzyme inhibition with quinapril improves endothelial vasomotor dysfunction in patients with coronary artery disease. The TREND (trial on reversing ENdothelial dysfunction) study","volume":"94","author":"Mancini","year":"1996","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B135","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.ahj.2021.03.011","article-title":"Rationale and design of the Women's Ischemia Trial to Reduce Events in Nonobstructive CAD (WARRIOR) trial","volume":"237","author":"Handberg","year":"2021","journal-title":"Am Heart J"},{"key":"2025100619514109800_ehaf284-B136","doi-asserted-by":"publisher","first-page":"e003863","DOI":"10.1161\/CIRCOUTCOMES.116.003863","article-title":"Ten-year mortality in the WISE study (Women's Ischemia Syndrome Evaluation)","volume":"10","author":"Kenkre","year":"2017","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2025100619514109800_ehaf284-B137","doi-asserted-by":"publisher","first-page":"e008868","DOI":"10.1161\/JAHA.118.008868","article-title":"Ischemia and No Obstructive Coronary Artery Disease (INOCA): what is the risk?","volume":"7","author":"Herscovici","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2025100619514109800_ehaf284-B138","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1161\/01.CIR.92.5.1094","article-title":"Long-term cigarette smoking impairs endothelium-dependent coronary arterial vasodilator function","volume":"92","author":"Zeiher","year":"1995","journal-title":"Circulation"},{"key":"2025100619514109800_ehaf284-B139","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1016\/j.jacc.2013.07.018","article-title":"Prognostic stratification of patients with vasospastic angina: a comprehensive clinical risk score developed by the Japanese Coronary Spasm Association","volume":"62","author":"Takagi","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B140","doi-asserted-by":"publisher","first-page":"e008126","DOI":"10.1161\/CIRCINTERVENTIONS.119.008126","article-title":"Ischemia and No obstructive coronary artery disease: prevalence and correlates of coronary vasomotion disorders","volume":"12","author":"Ford","year":"2019","journal-title":"Circ Cardiovasc Interv"},{"key":"2025100619514109800_ehaf284-B141","doi-asserted-by":"publisher","first-page":"e0240722","DOI":"10.1371\/journal.pone.0240722","article-title":"Comprehensive treatment of microvascular angina in overweight women\u2014a randomized controlled pilot trial","volume":"15","author":"Bove","year":"2020","journal-title":"PLoS One"},{"key":"2025100619514109800_ehaf284-B142","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1159\/000339224","article-title":"Cardiac rehabilitation to improve physical functioning in refractory angina: a pilot study","volume":"122","author":"Asbury","year":"2012","journal-title":"Cardiology"},{"key":"2025100619514109800_ehaf284-B143","doi-asserted-by":"publisher","first-page":"747","DOI":"10.36660\/abc.20210564","article-title":"Does myocardial injury occur after an acute aerobic exercise session in patients with refractory angina?","volume":"119","author":"Montenegro","year":"2022","journal-title":"Arq Bras Cardiol"},{"key":"2025100619514109800_ehaf284-B144","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis","volume":"67","author":"Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2025100619514109800_ehaf284-B145","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1007\/s11936-018-0667-2","article-title":"Cardiac rehabilitation and exercise prescription in symptomatic patients with non-obstructive coronary artery disease-a systematic review","volume":"20","author":"Kissel","year":"2018","journal-title":"Curr Treat Options Cardiovasc Med"},{"key":"2025100619514109800_ehaf284-B146","volume-title":"The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation","author":"British Association for Cardiovascular Prevention and Rehabilitation","year":"2023","edition":"4th edn"},{"key":"2025100619514109800_ehaf284-B147","doi-asserted-by":"publisher","first-page":"943","DOI":"10.36660\/abc.20200407","article-title":"Brazilian cardiovascular rehabilitation guideline\u20142020","volume":"114","author":"Carvalho","year":"2020","journal-title":"Arq Bras Cardiol"},{"key":"2025100619514109800_ehaf284-B148","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ijcard.2020.12.003","article-title":"Beneficial effects of exercise training on physical performance in patients with vasospastic angina","volume":"328","author":"Sugisawa","year":"2021","journal-title":"Int J Cardiol"},{"key":"2025100619514109800_ehaf284-B149","doi-asserted-by":"publisher","first-page":"69","DOI":"10.15420\/ecr.2016:26:1","article-title":"Management of refractory angina pectoris","volume":"11","author":"Cheng","year":"2016","journal-title":"Eur Cardiol"},{"key":"2025100619514109800_ehaf284-B150","doi-asserted-by":"publisher","first-page":"12","DOI":"10.5837\/bjc.2020.012","article-title":"A multi-disciplinary care pathway improves symptoms, QoL and medication use in refractory angina","volume":"27","author":"Cheng","year":"2020","journal-title":"Br J Cardiol"}],"container-title":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/38\/3738\/63636054\/ehaf284.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/38\/3738\/63636054\/ehaf284.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T23:51:49Z","timestamp":1759794709000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/46\/38\/3738\/8180268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":150,"journal-issue":{"issue":"38","published-online":{"date-parts":[[2025,7,1]]},"published-print":{"date-parts":[[2025,10,7]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehaf284","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10,7]]},"published":{"date-parts":[[2025,7,1]]}}}