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Updated: Jun 14, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
The Belgian Registry on Coronary Function Testing (BELmicro Registry): Study Population, Prevalence of Coronary
Tijs Bringmans1, Alice Benedetti2, Carlo Zivelonghi2
1Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium.
Insights
Coronary function testing (CFT) is safe and effective for diagnosing coronary microvascular dysfunction and vasospasm in patients with angina and nonobstructive coronary arteries (ANOCAs). The BELmicro registry shows high prevalence of these conditions and cardiovascular risk factors in real-world practice.
Area of Science:
- Cardiology
- Vascular Medicine
- Clinical Research
Background:
- Coronary function testing (CFT) is crucial for diagnosing coronary vascular dysfunction and guiding patient therapy.
- The Belgian registry on CFT (BELmicro registry) is a prospective, observational, multicenter study evaluating real-world CFT practices.
- Understanding the characteristics of patients undergoing CFT and the prevalence of specific coronary dysfunctions is essential.
Purpose of the Study:
- To describe baseline characteristics of patients undergoing CFT in a real-world setting.
- To evaluate the prevalence of coronary vascular dysfunction, including microvascular dysfunction and vasospasm.
- To assess the safety and feasibility of performing CFT in daily clinical practice.
Main Methods:
- Prospective, observational, multicenter registry (BELmicro registry) including 14 centers in Belgium.
- Inclusion of all patients undergoing clinically indicated CFT between October 2021 and September 2023.
- Collection of baseline characteristics, CFT data (microvascular physiology assessment, vasoreactivity testing), and clinical outcomes.
Main Results:
- 449 patients enrolled, with a mean age of 65 years and high prevalence of cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, smoking).
- Angina and nonobstructive coronary arteries (ANOCAs) identified in 85.1% of patients.
- Coronary microvascular dysfunction diagnosed in 23.4% of ANOCA patients, epicardial vasospasm in 26.3%, and microvascular spasm in 14.9%.
- Major complication rates were low: 0.7% for microvascular physiology assessment and 0% for vasoreactivity testing.
Conclusions:
- The BELmicro registry represents a real-world cohort with a significant burden of cardiovascular risk factors.
- Coronary microvascular dysfunction and vasospasm are common findings in patients with ANOCA.
- Coronary function testing is a feasible and safe procedure in routine clinical practice, with a low complication rate.
Abstract:
Coronary function testing (CFT) plays a pivotal role in the diagnosis of coronary vascular dysfunction and providing patients with tailored therapy. The Belgian registry on CFT (BELmicro registry) is a prospective, observational, multicenter registry including 14 centers in Belgium. All patients who underwent clinically indicated CFT were included in the registry. Baseline characteristics, CFT data, and clinical outcomes were collected. This analysis aimed to describe the baseline characteristics of a real-world population of patients who underwent CFT, evaluate the prevalence of coronary vascular dysfunction, and assess the safety of CFT in daily clinical practice. Between October 2021 and September 2023, 449 patients were enrolled. The mean age was 65 ± 10 years, and 47.4% of patients were men. A total of 59% of patients had hypertension, 18.7% had diabetes, 69.5% had hypercholesterolemia, and 40.1% had a smoking habit. Angina and nonobstructive coronary arteries (ANOCAs) were identified in 85.1% of the patients. Microvascular physiology assessment was performed in 95.5% of patients, vasoreactivity test in 28.5%, and both in 24.0%. coronary microvascular dysfunction was diagnosed in 23.4% of patients with ANOCA, epicardial vasospasm in 26.3%, and microvascular spasm in 14.9%. Rates of major complications were 0.7% for microvascular physiology assessment and 0% for vasoreactivity test. In conclusion, participants in the BELmicro registry represented a real-world population of patients, characterized by a high burden of cardiovascular risk factors. Coronary microvascular dysfunction and coronary vasospasm were frequent in patients with ANOCA. Performing CFT in daily clinical practice was feasible, with a low rate of complications.
