126 Chapter 6 CONCLUSION In this observational cross-sectional cohort study with a healthy control population, we documented a reduced myocardial blood volume in ANOCA patients at baseline, during hyperinsulinemia and dobutamine-induced stress in the absence of differences in microvascular recruitment. These findings support the presence of capillary rarefaction in ANOCA patients as a pathophysiological phenomenon involved in this complex clinical syndrome. Our findings provide valuable insight into the role of reduced MBV in ANOCA pathophysiology, independently of MBF. Despite reduced insulin-sensitivity in ANOCA patients, the effect of insulin on capillary recruitment in the myocardium remained unaltered.
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