Case Analysis: AngioQFA Enables Precise Diagnosis of Coronary Microvascular Dysfunction at a Shanghai General Hospital
RaysightMed
Medical Imaging Product Developer
2025YearIn mid-September, the cardiology department of a comprehensive hospital in Shanghai successfully introduced the RaysightMed AngioQFA system, applying it to the entire diagnosis and treatment process of an elderly female patient with angina. This technology is based on coronary angiography images.One-stop precise assessment of epicardial coronary flow reserve fraction (FFR) and microcirculatory resistance index (IMR) provides key functional evidence for clinical decision-making, ultimately guiding patients toward more reasonable medication treatment pathways.。
Patient Ms. Wang (pseudonym),77 years old, admitted to the hospital for "paroxysmal chest tightness, palpitations, and heart palpitations for 3 years, worsening in the past 2 months."
The results of the auxiliary examination are as follows:
- ECG: Sinus bradycardia, T wave changes (low or biphasic in high lateral, inferior, and V4-V6 leads)
- Echocardiography: Mild aortic and tricuspid regurgitation, decreased left ventricular diastolic function
- Coronary angiography: LAD, LCX, and RCA show multiple 30-40% stenoses, which are considered mild.
AngioQFA Assessment Reveals Etiology
Although coronary angiography showed only mild vascular stenosis, to further clarify whether there is functional ischemia, the doctor used RaysightMed.AThe ngioQFA system conducted a comprehensive assessment of the patient., Results are as follows:
- LAD distal segment (30-40% stenosis): Angio-FFR 0.86, Angio-IMR 40.12
- LCX distal segment (30-40% stenosis): Angio-FFR 0.94, Angio-IMR 34.29
- RCA proximal and distal segments (30-40% stenosis)：Angio-FFR 0.95，Angio-IMR 15.54
Comprehensive Judgment:FFR value is negative, IMR suggests significant microcirculatory dysfunction.
Diagnosis and Treatment Decision-Making and Clinical Value
CombineAngioQFA Evaluation Results: The patient is considered to be diagnosed with:
Coronary Heart Disease, Coronary Microcirculation Dysfunction.
Based on this, the clinical team developed a conservative treatment plan centered on intensified medication and regular follow-up, without stent implantation.
In this case, RaysightMedAngioQFA Demonstrates Three Core Clinical Values:
1. Identify the Cause
InCoronaryImaging shows" Mild stenosis " context,FurtherThroughFFR+IMRUnitedSynchronous assessment,ClearPatientClinicalMain SymptomsThe pathogenic factors areMicrocirculatory dysfunction, rather than epicardial coronaryExistSignificant ischemia.
2. Avoid Over-intervention
All vesselsFFR values were all above 0.80, with no clear evidence of flow limitation; thus, there was no indication for stent implantation. AngioQFA effectively assists doctors in making the precise decision of "no intervention," avoiding unnecessary stent implantation and the related long-term medication burden for patients.
3. Improve Long-term Prognosis
Based on the precise diagnosis of microvascular disease, throughThe combination of "targeted drug therapy + regular follow-up" not only successfully controlled the patient's symptoms but also reduced the economic burden and bleeding risks associated with long-term use of dual antiplatelet drugs, making chronic disease management more efficient and safer.
This case shows that in patients with mild coronary artery stenosis combined with chest tightness symptoms,AngioQFA, by synchronously assessing FFR and IMR, effectively identifies microcirculatory dysfunction, the "invisible lesion," advancing precise diagnosis and personalized treatment. As a one-stop coronary functional FFR+IMR assessment platform, RaysightMed AngioQFA is providing comprehensive and accurate cardiovascular functional evaluation methods in over 200 hospitals across China, assisting clinicians in making more precise decisions in the clinical pathway.
