cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2023-38-2-30-37cardiotomsk-1784Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОсобенности диагностики и лечения ишемической болезни сердца у пациентов без обструктивного атеросклеротического поражения коронарных артерийFeatures of diagnosis and treatment of coronary heart disease in patients without obstructive atherosclerotic lesions of the coronary arterieshttps://orcid.org/0000-0001-8619-6478УтегеновР. Б.UtegenovR. B.

Утегенов Руслан Булатович - врач по рентген-эндоваскулярным диагностике и лечению, младший научный сотрудник

625026, Российская Федерация, Тюмень, ул. Мельникайте, 111 

Ruslan B. Utegenov - Surgeon, Department of Interventional Radiology Diagnostics and Treatment, Junior Research Scientific 

 111, Melnikaite str., Tyumen, 625026, Russian Federation 

ruslanutegenov8776@gmail.comhttps://orcid.org/0000-0003-0578-5962БессоновИ. С.BessonovI. S.

Бессонов Иван Сергеевич - канд. мед. наук, заведующий лабораторией рентген-эндоваскулярных методов диагностики и лечения 

625026, Российская Федерация, Тюмень, ул. Мельникайте, 111 

Ivan S. Bessonov - Cand. Sci. (Med.), Head, Interventional CardiologyLaboratory

 111, Melnikaite str., Tyumen, 625026, Russian Federation 

Тюменский кардиологический научный центр, Томский национальный исследовательский медицинский центр Российской академии наукРоссияTyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of SciencesRussian Federation2023030720233823037Copyright © Утегенов Р.Б., Бессонов И.С., 20232023Утегенов Р.Б., Бессонов И.С.Utegenov R.B., Bessonov I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/1784

В половине случаев у пациентов с хронической ишемической болезнью сердца (ИБС) при выполнении коронароангиографии (КАГ) не определяется обструктивного поражения коронарных артерий (КА). Чаще всего такие больные имеют вазоспастическую форму стенокардии (ВСС) и/или микрососудистую стенокардию (МСС). Эти пациенты могут подвергаться неоднократным диагностическим тестированиям, в том числе выполнению селективной коронарографии, но в конечном итоге правильный диагноз им так и не устанавливается. В настоящем обзоре представлены современные патогенетические механизмы развития и методы диагностики ишемии миокарда без обструктивного поражения КА. Также освещаются вопросы выбора тактики лечения в соответствии с выявленным патогенетическим механизмом развития ИБС.

In half of cases during coronary angiography (CAG), obstructive coronary artery lesions aren’t detected in patients with chronic coronary artery disease. Such patients mostly have vasospastic angina (VSA) and/or microvascular angina (MVA). These patients can be performed repeated diagnostic tests, including selective coronary angiography, but as a result they are never diagnosed correctly. This review presents modern pathogenetic mechanisms for the development and methods of diagnosing of ischemia with non-obstructive coronary artery disease. It also highlights choice of treatment tactics in accordance with the identified pathophysiological mechanism for the development of chronic coronary artery disease.

вазоспастическая стенокардиямикрососудистая стенокардиякоронароангиографияацетилхолиновая пробакоронарный резерв кровотокаиндекс микроциркуляторной резистентностиvasospastic anginamicrovascular anginacoronary angiographyacetylcholine testcoronary flow reserveindex of microcirculatory resistanceReferencesFord T.J., Stanley B., Good R., Rocchiccioli P., McEntegart M., Watkins S. et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J. Am. Coll. Cardiol. 2018;72(23, Part A):2841–2855. DOI: 10.1016/j.jacc.2018.09.006.Ford T.J., Stanley B., Good R., Rocchiccioli P., McEntegart M., Watkins S. et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J. Am. Coll. Cardiol. 2018;72(23, Part A):2841–2855. DOI: 10.1016/j.jacc.2018.09.006.Алекян Б.Г., Григорьян А.М., Стаферов А.В., Карапетян Н.Г. Рентгенэндоваскулярная диагностика и лечение сердца и сосудов в Российской Федерации – 2020 год. Эндоваскулярная хирургия. 2021;спец. вып.(8):S5–S248. DOI: 10.24183/2409-4080-2021-8SS5-S248.Alekyan B.G., Grigoryan A.M., Staferov A.V., Karapetyan N.G. X-ray endovascular diagnostic and treatment of the heart and blood vessels in the Russian Federation. Endovascular surgery. 2020;special issue(8):S5–S248. (In Russ.). DOI: 10.24183/2409-4080-2021-8SS5-S248.Сумин А. Н. Проблема интактных коронарных артерий еще остается или близка к решению? Российский кардиологический журнал. 2021;26(2):4139. DOI: 10.15829/1560-4071-2021-4139.Sumin A.N. Is the problem of intact coronary arteries still or is it close to solving? Russian Journal of Cardiology. 2021;26(2):4139. (In Russ.). DOI: 10.15829/1560-4071-2021-4139.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur. Heart J. 2020;41(3):407–477. DOI: 10.1093/eurheartj/ehz425.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur. Heart J. 2020;41(3):407–477. DOI: 10.1093/eurheartj/ehz425.Ford T.J., Stanley B., Sidik N., Good R., Rocchiccioli P., McEntegart M. et al. 1-Year Outcomes of Angina Management Guided by Invasive Coronary Function Testing (CorMicA). JACC Cardiovasc. Interv. 2020;13(1):33–45. DOI: 10.1016/j.jcin.2019.11.001.Ford T.J., Stanley B., Sidik N., Good R., Rocchiccioli P., McEntegart M. et al. 1-Year Outcomes of Angina Management Guided by Invasive Coronary Function Testing (CorMicA). JACC Cardiovasc. Interv. 2020;13(1):33–45. DOI: 10.1016/j.jcin.2019.11.001.Beltrame J.F., Crea F., Kaski J.C., Ogawa H., Ong P., Sechtem U. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for vasospastic angina. Eur. Heart. J. 2017;38(33):2565–2568. DOI: 10.1093/eurheartj/ehv351.Beltrame J.F., Crea F., Kaski J.C., Ogawa H., Ong P., Sechtem U. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for vasospastic angina. Eur. Heart. J. 2017;38(33):2565–2568. DOI: 10.1093/eurheartj/ehv351.Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ. J. 2014;78(11):2779–2801. DOI: 10.1253/circj.cj-66-0098.Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ. J. 2014;78(11):2779–2801. DOI: 10.1253/circj.cj-66-0098.Sueda S., Kohno H., Ochi T., Uraoka T., Tsunemitsu K. Overview of the pharmacological spasm provocation test: Comparisons between acetylcholine and ergonovine. J. Cardiol. 2017;69(1):57–65. DOI: 10.1016/j.jjcc.2016.09.012.Sueda S., Kohno H., Ochi T., Uraoka T., Tsunemitsu K. Overview of the pharmacological spasm provocation test: Comparisons between acetylcholine and ergonovine. J. Cardiol. 2017;69(1):57–65. DOI: 10.1016/j.jjcc.2016.09.012.Sueda S., Sakaue T. Intracoronary acetylcholine testing among 746 consecutive Japanese patients with angina-like chest pain and unobstructed coronary artery disease. European Heart Journal Open. 2022;2(1):oeab012. DOI: 10.1093/ehjopen/oeab012.Sueda S., Sakaue T. Intracoronary acetylcholine testing among 746 consecutive Japanese patients with angina-like chest pain and unobstructed coronary artery disease. European Heart Journal Open. 2022;2(1):oeab012. DOI: 10.1093/ehjopen/oeab012.Hoshino M., Yonetsu T., Mizukami A., Matsuda Y., Yoshioka K., Sudo Y. et al. Moderate vasomotor response to acetylcholine provocation test as an indicator of long-term prognosis. Heart Vessels. 2016;31(12):1943–1949. DOI: 10.1007/s00380-016-0827-9.Hoshino M., Yonetsu T., Mizukami A., Matsuda Y., Yoshioka K., Sudo Y. et al. Moderate vasomotor response to acetylcholine provocation test as an indicator of long-term prognosis. Heart Vessels. 2016;31(12):1943–1949. DOI: 10.1007/s00380-016-0827-9.Обединский А.А., Бугуров С.В., Крестьянинов О.В., Нарышкин И.А., Зубарев Д.Д., Гражданкин И.О. и др. Современные возможности диагностики вазоспастической стенокардии: провокационное интракоронарное тестирование. Патология кровообращения и кардиохирургия. 2017;21(1):98–103. DOI: 10.21688/1681-3472-2017-1-98-103.Obedinskiy A.A., Bugurov S.V., Krestyaninov O.V., Naryshkin I.A., Zubarev D.D., Grazhdankin I.O. et al. Modern diagnostic capabilities for vasospastic angina diagnostics (intracoronary provocative testing). Circulation Pathology and Cardiac Surgery. 2017;21(1):98–103. (In Russ.). DOI: 10.21688/1681-3472-2017-1-98-103.Padro T., Manfrini O., Bugiardini R., Canty J., Cenko E., De Luca G. et al. ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on “coronary microvascular dysfunction in cardiovascular disease”. Cardiovasc. Res. 2020;116(4):741–755. DOI: 10.1093/cvr/cvaa003.Padro T., Manfrini O., Bugiardini R., Canty J., Cenko E., De Luca G. et al. ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on “coronary microvascular dysfunction in cardiovascular disease”. Cardiovasc. Res. 2020;116(4):741–755. DOI: 10.1093/cvr/cvaa003.Ong P., Camici P.G., Beltrame J.F., Crea F., Shimokawa H., Sechtem U. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for microvascular angina. Int. J. Cardiol. 2018;250:16–20. DOI: 10.1016/j.ijcard.2017.08.068.Ong P., Camici P.G., Beltrame J.F., Crea F., Shimokawa H., Sechtem U. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for microvascular angina. Int. J. Cardiol. 2018;250:16–20. DOI: 10.1016/j.ijcard.2017.08.068.Konst R.E., Meeder J.G., Wittekoek M.E., Maas A.H.E.M., Appel man Y., Piek J.J. et al. Ischaemia with no obstructive coronary arteries. Neth. Heart J. 2020(Suppl. 1):66–72. DOI: 10.1007/s12471-020-01451-9.Konst R.E., Meeder J.G., Wittekoek M.E., Maas A.H.E.M., Appel man Y., Piek J.J. et al. Ischaemia with no obstructive coronary arteries. Neth. Heart J. 2020(Suppl. 1):66–72. DOI: 10.1007/s12471-020-01451-9.Jansen T.P.J., Konst R.E, Elias-Smale S.E., van den Oord S.C., Ong P., de Vos A.M.J. et al. Assessing Microvascular Dysfunction in Angina With Unobstructed Coronary Arteries: JACC Review Topic of the Week. J. Am. Coll. Cardiol. 2021;78(14):1471–1479. DOI: 10.1016/j.jacc.2021.08.028.Jansen T.P.J., Konst R.E, Elias-Smale S.E., van den Oord S.C., Ong P., de Vos A.M.J. et al. Assessing Microvascular Dysfunction in Angina With Unobstructed Coronary Arteries: JACC Review Topic of the Week. J. Am. Coll. Cardiol. 2021;78(14):1471–1479. DOI: 10.1016/j.jacc.2021.08.028.De Silva R., Cheng K. Microvascular angina: quo tendimus? Eur. Heart J. 2021;42(44):4601–4604. DOI: 10.1093/eurheartj/ehab534.De Silva R., Cheng K. Microvascular angina: quo tendimus? Eur. Heart J. 2021;42(44):4601–4604. DOI: 10.1093/eurheartj/ehab534.McCallinhart P.E., Scandling B.W., Trask A.J.. Coronary remodeling and biomechanics: Are we going with the flow in 2020? Am. J. Physiol. Heart Circ. Physiol. 2021;320(2):H584–H592. DOI: 10.1152/ajpheart.00634.2020.McCallinhart P.E., Scandling B.W., Trask A.J.. Coronary remodeling and biomechanics: Are we going with the flow in 2020? Am. J. Physiol. Heart Circ. Physiol. 2021;320(2):H584–H592. DOI: 10.1152/ajpheart.00634.2020.McCallinhart P.E., Sunyecz I.L., Trask A.J. Coronary Microvascular Remodeling in Type 2 Diabetes: Synonymous With Early Aging? Front. Physiol. 2018;9:1463. DOI: 10.3389/fphys.2018.01463.McCallinhart P.E., Sunyecz I.L., Trask A.J. Coronary Microvascular Remodeling in Type 2 Diabetes: Synonymous With Early Aging? Front. Physiol. 2018;9:1463. DOI: 10.3389/fphys.2018.01463.Crea F., Montone R.A., Rinaldi R. Pathophysiology of Coronary Microvascular Dysfunction. Circ. J. 2021;2022;86(9):1319–1328. DOI: 10.1253/circj.CJ-21-0848.Crea F., Montone R.A., Rinaldi R. Pathophysiology of Coronary Microvascular Dysfunction. Circ. J. 2021;2022;86(9):1319–1328. DOI: 10.1253/circj.CJ-21-0848.Vancheri F., Longo G., Vancheri S., Henein M. Coronary Microvascular Dysfunction. J. Clin. Med. 2020;9(9):2880. DOI: 10.3390/jcm9092880.Vancheri F., Longo G., Vancheri S., Henein M. Coronary Microvascular Dysfunction. J. Clin. Med. 2020;9(9):2880. DOI: 10.3390/jcm9092880.Masi S., Rizzoni D., Taddei S., Widmer R.J., Montezano A.C., Lüscher T.F. et al. Assessment and pathophysiology of microvascular disease: recent progress and clinical implications. Eur. Heart J. 2021;42(26):2590–2604. DOI: 10.1093/eurheartj/ehaa857.Masi S., Rizzoni D., Taddei S., Widmer R.J., Montezano A.C., Lüscher T.F. et al. Assessment and pathophysiology of microvascular disease: recent progress and clinical implications. Eur. Heart J. 2021;42(26):2590–2604. DOI: 10.1093/eurheartj/ehaa857.Ada C., Yong A. Assessment of the coronary microcirculation in the cardiac catheterisation laboratory. Vessel Plus. 2021;5:1–13. DOI: 10.20517/2574-1209.2021.51.Ada C., Yong A. Assessment of the coronary microcirculation in the cardiac catheterisation laboratory. Vessel Plus. 2021;5:1–13. DOI: 10.20517/2574-1209.2021.51.Cziráki A., Lenkey Z., Sulyok E., Szokodi I., Koller A. L. Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice. Front. Pharmacol. 2020;11:569914. DOI: 10.3389/fphar.2020.569914.Cziráki A., Lenkey Z., Sulyok E., Szokodi I., Koller A. L. Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice. Front. Pharmacol. 2020;11:569914. DOI: 10.3389/fphar.2020.569914.Gutiérrez E., Flammer A.J., Lerman L.O., Elízaga J., Lerman A., Fernández-Avilés F. Endothelial dysfunction over the course of coronary artery disease. Eur. Heart J. 2013;34(41):3175–3181. DOI: 10.1093/eurheartj/eht351.Gutiérrez E., Flammer A.J., Lerman L.O., Elízaga J., Lerman A., Fernández-Avilés F. Endothelial dysfunction over the course of coronary artery disease. Eur. Heart J. 2013;34(41):3175–3181. DOI: 10.1093/eurheartj/eht351.Taqueti V.R., Di Carli M.F. Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options: JACC State-of-the-Art Review. J. Am. Coll. Cardiol. 2018;72(21):2625–2641. DOI: 10.1016/j.jacc.2018.09.042.Taqueti V.R., Di Carli M.F. Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options: JACC State-of-the-Art Review. J. Am. Coll. Cardiol. 2018;72(21):2625–2641. DOI: 10.1016/j.jacc.2018.09.042.Xu S., Ilyas I., Little P.J., Li H., Kamato D., Zheng X. et al. Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies. Pharmacol. Rev. 2021;73(3):924–967. DOI: 10.1124/pharmrev.120.000096.Xu S., Ilyas I., Little P.J., Li H., Kamato D., Zheng X. et al. Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies. Pharmacol. Rev. 2021;73(3):924–967. DOI: 10.1124/pharmrev.120.000096.Gutiérrez E., Gómez-Lara J., Escaned J., Cruz I., Ojeda S., Romaguera R. Assessment of the endothelial function and spasm provocation test performed by intracoronary infusion of acetylcholine. Technical report from the ACI-SEC. REC Interv. Cardiol. 2021;3(4):286–296. DOI: 10.24875/RECICE.M21000215.Gutiérrez E., Gómez-Lara J., Escaned J., Cruz I., Ojeda S., Romaguera R. Assessment of the endothelial function and spasm provocation test performed by intracoronary infusion of acetylcholine. Technical report from the ACI-SEC. REC Interv. Cardiol. 2021;3(4):286–296. DOI: 10.24875/RECICE.M21000215.Schroder J., Prescott E. Doppler Echocardiography Assessment of Coronary Microvascular Function in Patients With Angina and No Obstructive Coronary Artery Disease. Front. Cardiovasc. Med. 2021;8:723542. DOI: 10.3389/fcvm.2021.723542.Schroder J., Prescott E. Doppler Echocardiography Assessment of Coronary Microvascular Function in Patients With Angina and No Obstructive Coronary Artery Disease. Front. Cardiovasc. Med. 2021;8:723542. DOI: 10.3389/fcvm.2021.723542.Camici P.G., D’Amati G., Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat. Rev. Cardiol. 2015;12(1):48–62. DOI: 10.1038/nrcardio.2014.160.Camici P.G., D’Amati G., Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat. Rev. Cardiol. 2015;12(1):48–62. DOI: 10.1038/nrcardio.2014.160.Carbone A., D’Andrea A., Sperlongano S., Tagliamonte E., Mandoli G.E., Santoro C. et al. Echocardiography study group of the Italian Society of Cardiology. Echocardiographic assessment of coronary microvascular dysfunction: Basic concepts, technical aspects, and clinical settings. Echocardiography. 2021;38(6):993–1001. DOI: 10.1111/echo.15059.Carbone A., D’Andrea A., Sperlongano S., Tagliamonte E., Mandoli G.E., Santoro C. et al. Echocardiography study group of the Italian Society of Cardiology. Echocardiographic assessment of coronary microvascular dysfunction: Basic concepts, technical aspects, and clinical settings. Echocardiography. 2021;38(6):993–1001. DOI: 10.1111/echo.15059.Indorkar R., Kwong R.Y., Romano S., White B.E., Chia R.C., Trybula M. et al. Global Coronary Flow Reserve Measured During Stress Cardiac Magnetic Resonance Imaging Is an Independent Predictor of Adverse Cardiovascular Events. JACC Cardiovasc. Imaging. 2019;12(8, Part 2):1686–1695. DOI: 10.1016/j.jcmg.2018.08.018.Indorkar R., Kwong R.Y., Romano S., White B.E., Chia R.C., Trybula M. et al. Global Coronary Flow Reserve Measured During Stress Cardiac Magnetic Resonance Imaging Is an Independent Predictor of Adverse Cardiovascular Events. JACC Cardiovasc. Imaging. 2019;12(8, Part 2):1686–1695. DOI: 10.1016/j.jcmg.2018.08.018.Schindler T.H., Dilsizian V. Coronary Microvascular Dysfunction: Clinical Considerations and Noninvasive Diagnosis. JACC Cardiovasc. Imaging. 2020;13(1, Part 1):140–155. DOI: 10.1016/j.jcmg.2018.11.036.Schindler T.H., Dilsizian V. Coronary Microvascular Dysfunction: Clinical Considerations and Noninvasive Diagnosis. JACC Cardiovasc. Imaging. 2020;13(1, Part 1):140–155. DOI: 10.1016/j.jcmg.2018.11.036.Schindler T.H. Myocardial blood flow: Putting it into clinical perspective. J. Nucl. Cardiol. 2016;23(5):1056–1071. DOI: 10.1007/s12350-015-0372-4.Schindler T.H. Myocardial blood flow: Putting it into clinical perspective. J. Nucl. Cardiol. 2016;23(5):1056–1071. DOI: 10.1007/s12350-015-0372-4.Сумин А.Н., Корок Е.В., Короткевич А.А., Качурина Е.Н., Коков А.Н., Барбараш О.Л. Сложности диагностики обструктивных поражений коронарных артерий при стабильной ишемической болезни сердца и возможности однофотонной эмиссионной компьютерной томографии. Кардиология. 2019;59(1):28–35. DOI: 10.18087/cardio.2019.1.10226.Sumin A.N., Korok E.V., Korotkevitch A.A., Kachurina E.N., Kokov A.N., Barbarash O.L. Difficulties of Diagnostics of Obstructive Coronary Artery Lesions in Patients with Stable Ischemic Heart Disease and Possibilities of Single-Photon Emission Computed Tomography. Kardiologiia. 2019;59(1):28–35. (In Russ.). DOI: 10.18087/cardio.2019.1.10226.Мальцева А.Н., Мочула А.В., Копьева К.В., Гракова Е.В., Завадовский К.В. Радионуклидные методы исследования в диагностике микроваскулярной дисфункции при необструктивном атеросклеротическом поражении коронарных артерий. Российский кардиологический журнал. 2021;26(12):4746. DOI: 10.15829/1560-4071-2021-4746.Maltseva A.N., Mochula A.V., Kopyeva K.V., Grakova E.V., Zavadovsky K.V. Radionuclide imaging methods in the diagnosis of microvascular dysfunction in non-obstructive coronary artery disease. Russian Journal of Cardiology. 2021;26(12):4746. (In Russ.). DOI: 10.15829/1560-4071-2021-4746.Минин С.М., Завадовский К.В., Никитин Н.А., Мочула А.В., Романов А.Б. Современные возможности кардиовизуализации с использованием гамма-камер, оснащенных CZT-детекторами. Патология кровообращения и кардиохирургия. 2020;24(3):11–22. DOI: 10.21688/1681-3472-2020-3-11-22.Minin S.M., Zavadovky K.V., Nikitin N.A., Mochula A.V., Romanov A.B. Modern possibilities of cardiovascular imaging using gamma cameras with cadmium–zinc–telluride-detectors. Patologiya krovoobrashcheniya I kardiokhirurgiya =Circulation Pathology and Cardiac Surgery. 2020;24(3):11-22. (In Russ.). DOI: 10.21688/1681-3472-2020-3-11-22.Zavadovsky K.V., Mochula A.V., Boshchenko A.A., Vrublevsky A.V., Baev A.E., Krylov A.L. et al. Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy. J. Nucl. Cardiol. 2021;28(1):249–259. DOI: 10.1007/s12350-019-01678-z.Zavadovsky K.V., Mochula A.V., Boshchenko A.A., Vrublevsky A.V., Baev A.E., Krylov A.L. et al. Absolute myocardial blood flows derived by dynamic CZT scan vs invasive fractional flow reserve: Correlation and accuracy. J. Nucl. Cardiol. 2021;28(1):249–259. DOI: 10.1007/s12350-019-01678-z.Kim S.E., Jo S.H., Han S.H., Lee K.Y., Her S.H., Lee M.H. et al. Comparison of calcium-channel blockers for long-term clinical outcomes in patients with vasospastic angina. Korean J. Intern. Med. 2020;36(1):124–134. DOI: 10.3904/kjim.2019.308.Kim S.E., Jo S.H., Han S.H., Lee K.Y., Her S.H., Lee M.H. et al. Comparison of calcium-channel blockers for long-term clinical outcomes in patients with vasospastic angina. Korean J. Intern. Med. 2020;36(1):124–134. DOI: 10.3904/kjim.2019.308.Kosugi M., Nakagomi A., Shibui T., Katsuhito K., Kusama Y., Atarashi H. et al. Effect of long-term nitrate treatment on cardiac events in patients with vasospastic angina. Circ. J. 2011;75(9):2196–205. DOI: 10.1253/circj.cj-11-0056.Kosugi M., Nakagomi A., Shibui T., Katsuhito K., Kusama Y., Atarashi H. et al. Effect of long-term nitrate treatment on cardiac events in patients with vasospastic angina. Circ. J. 2011;75(9):2196–205. DOI: 10.1253/circj.cj-11-0056.Bairey Merz C.N., Pepine C.J., Shimokawa H., Berry C. Treatment of coronary microvascular dysfunction. Cardiovasc. Res. 2020;116(4):856–870. DOI: 10.1093/cvr/cvaa006.Bairey Merz C.N., Pepine C.J., Shimokawa H., Berry C. Treatment of coronary microvascular dysfunction. Cardiovasc. Res. 2020;116(4):856–870. DOI: 10.1093/cvr/cvaa006.

The authors declare that there are no conflicts of interest present.