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Updated: Mar 25, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

6.1K

Diagnostic Yield and Testing Characteristics of an Invasive Coronary Function Testing Program

Fouad Bitar1,2, Roukoz Abou-Karam1,2, Shoshana Gady1,2

  • 1Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 24, 2026
PubMed

Insights

Invasive coronary function testing (CFT) accurately diagnoses conditions like angina without obstructive coronary arteries (ANOCA) and guides treatment changes in over 70% of patients. This safe, high-yield program improves management for non-obstructive coronary artery disease.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Interventional Cardiology

Background:

  • Angina, ischemia, or myocardial infarction without non-obstructive coronary arteries (ANOCA, INOCA, or MINOCA) are frequently underdiagnosed.
  • Invasive coronary function testing (CFT), including coronary thermodilution and reactivity testing, offers accurate diagnostic capabilities.

Purpose of the Study:

  • To evaluate the diagnostic yield of an invasive CFT program.
  • To present findings from coronary thermodilution and reactivity testing in 104 patients.
  • To assess changes in patient management following CFT.

Main Methods:

  • Retrospective cohort study of 104 consecutive patients undergoing invasive CFT.
  • Descriptive statistics used to summarize patient characteristics, diagnostic outcomes, and management changes.
  • Analysis included coronary thermodilution and coronary reactivity testing.

Main Results:

  • A definitive diagnosis was achieved in 71.2% of patients.
  • Diagnoses included epicardial coronary spasm (27%), microvascular spasm (9%), endothelial dysfunction (6%), coronary microvascular dysfunction (CMD) (13%), and mixed phenotypes (17%).
  • Management changes occurred in 73% of patients, primarily involving antianginal therapy adjustments.

Conclusions:

  • An invasive CFT program can be safely implemented with a high diagnostic yield.
  • CFT leads to significant changes in antianginal therapy for patients with non-obstructive coronary artery disease.
  • The study highlights the value of CFT in diagnosing and managing complex coronary artery conditions.
Abstract

Keywords:
ANOCAINOCAcoronary microvascular diseasecoronary reactivity testingcoronary thermodilutioninvasive coronary function testing

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