{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:54:04Z","timestamp":1792684444417,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"\n Background<\/jats:title>\n The majority of women with angina\u2010like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n After screening 3568 women, 963 women with angina\u2010like chest pain and a diagnostic coronary angiogram without significant coronary artery stenosis (<50%) were consecutively included. Mean age (\n SD<\/jats:styled-content>\n ) was 62.1 (9.7). Assessment included demographic and clinical data, blood samples, questionnaires, and transthoracic echocardiography during rest and high\u2010dose dipyridamole (0.84\u00a0mg\/kg) with measurement of coronary flow velocity reserve (\n CFVR<\/jats:styled-content>\n ) by Doppler examination of the left anterior descending coronary artery.\n CFVR<\/jats:styled-content>\n was successfully measured in 919 (95%) women. Median (\n IQR<\/jats:styled-content>\n )\n CFVR<\/jats:styled-content>\n was 2.33 (1.98\u20132.76), and 241 (26%) had markedly impaired\n CFVR<\/jats:styled-content>\n (<2). In multivariable regression analysis, predictors of impaired\n CFVR<\/jats:styled-content>\n were age (\n P<\/jats:italic>\n <0.01), hypertension (\n P<\/jats:italic>\n =0.02), current smoking (\n P<\/jats:italic>\n <0.01), elevated heart rate (\n P<\/jats:italic>\n <0.01), and low high\u2010density lipoprotein cholesterol (\n P<\/jats:italic>\n =0.02), but these variables explained only a little of the\n CFVR<\/jats:styled-content>\n variation (\n r<\/jats:italic>\n 2<\/jats:sup>\n =0.09).\n CFVR<\/jats:styled-content>\n was not associated with chest pain characteristics or results from diagnostic stress testing.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Impaired\n CFVR<\/jats:styled-content>\n was detected in a substantial proportion, which suggests that coronary microvascular dysfunction plays a role in the development of angina pectoris.\n CFVR<\/jats:styled-content>\n was associated with few cardiovascular risk factors, suggesting that\n CFVR<\/jats:styled-content>\n is an independent parameter in the risk evaluation of these women. Symptom characteristics and results from stress testing did not identify individuals with impaired\n CFVR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.003064","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T22:53:41Z","timestamp":1458082421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":188,"title":["Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease: The iPOWER Study"],"prefix":"10.1161","volume":"5","author":[{"given":"Naja Dam","family":"Mygind","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark"},{"name":"Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Mide","family":"Michelsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Pena","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Frestad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nynne","family":"Dose","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekka","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nis","family":"H\u00f8st","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Riis","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik Steen","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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