{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:18:31Z","timestamp":1791649111916,"version":"4.3.4"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In patients with Ischemia and non-obstructive coronary artery stenosis (INOCA) wall motion is rarely abnormal during stress echocardiography (SE). Our aim was to determine if patients with INOCA and reduced coronary flow velocity reserve (CVFR) have altered cardiac mechanics using two-dimensional speckle-tracking echocardiography (2DSTE) during SE. Methods: In a prospective, multicenter, international study, we recruited 135 patients with INOCA. Overall, we performed high dose (0.84 mg\/kg) dipyridamole SE with combined assessment of CVFR and 2DSTE. The population was divided in patients with normal CVFR (&gt;2, group 1, n = 95) and abnormal CVFR (\u22642, group 2, n = 35). Clinical and 2DSTE parameters were compared between groups. Results: Feasibility was high for CFVR (98%) and 2DSTE (97%). A total of 130 patients (mean age 63 \u00b1 12 years, 67 women) had complete flow and strain data. The two groups showed similar 2DSTE values at rest. At peak SE, Group 1 patients showed lower global longitudinal strain (p &lt; 0.007), higher mechanical dispersion (p &lt; 0.0005), lower endocardial (p &lt; 0.001), and epicardial (p &lt; 0.0002) layer specific strain. Conclusions: In patients with INOCA, vasodilator SE with simultaneous assessment of CFVR and strain is highly feasible. Coronary microvascular dysfunction is accompanied by an impairment of global and layer-specific deformation indices during stress.<\/jats:p>","DOI":"10.3390\/jcm11030711","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T05:26:17Z","timestamp":1643433977000},"page":"711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Vasodilator Strain Stress Echocardiography in Suspected Coronary Microvascular Angina"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0336-5593","authenticated-orcid":false,"given":"Hugo","family":"Rodriguez-Zanella","sequence":"first","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0652-3913","authenticated-orcid":false,"given":"Rosina","family":"Arbucci","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos Investigaciones Medicas, Buenos Aires C1082, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-2861","authenticated-orcid":false,"given":"Juan Francisco","family":"Fritche-Salazar","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7605-2008","authenticated-orcid":false,"given":"Xochitl Arely","family":"Ortiz-Leon","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-0306","authenticated-orcid":false,"given":"Domenico","family":"Tuttolomondo","sequence":"additional","affiliation":[{"name":"Cardiology Department Parma University Hospital, 43100 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Haber","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos Investigaciones Medicas, Buenos Aires C1082, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7623-5389","authenticated-orcid":false,"given":"Karina","family":"Wierzbowska-Drabik","sequence":"additional","affiliation":[{"name":"I Department of Cardiology, Bieganski Hospital, Medical University, 91-347 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-8380","authenticated-orcid":false,"given":"Quirino","family":"Ciampi","sequence":"additional","affiliation":[{"name":"Cardiology Division Fatebenefratelli Hospital, 82100 Benevento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5850-8187","authenticated-orcid":false,"given":"Jaros\u0142aw D.","family":"Kasprzak","sequence":"additional","affiliation":[{"name":"I Department of Cardiology, Bieganski Hospital, Medical University, 91-347 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2207-3388","authenticated-orcid":false,"given":"Nicola","family":"Gaibazzi","sequence":"additional","affiliation":[{"name":"Cardiology Department Parma University Hospital, 43100 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos Investigaciones Medicas, Buenos Aires C1082, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3749-4281","authenticated-orcid":false,"given":"Edith Liliana","family":"Posada-Martinez","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7658-6146","authenticated-orcid":false,"given":"Jose Antonio","family":"Arias-Godinez","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"de la Fuente-Mancera","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Chavez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Picano","sequence":"additional","affiliation":[{"name":"CNR Institute of Clinical Physiology Biomedicine Department, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Stress Echo 2020 Study Group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1161\/CIRCULATIONAHA.116.024534","article-title":"Ischemia and No Obstructive Coronary Artery Disease 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