Invasive evaluation of coronary microvascular dysfunction

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Travieso, Alejandro and Jeronimo Baza, Adrian and Faria, Daniel and Shabbir, Asad and Mejía Rentería, Hernán David and Escaned Barbosa, Javier (2022) Invasive evaluation of coronary microvascular dysfunction. Journal of Nuclear Cardiology . ISSN 1071-3581

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Official URL: https://doi.org/10.1007/s12350-022-02997-4



Abstract

Coronary microvascular dysfunction (CMD) is a prevalent cause of ischemic heart disease and is associated with poorer quality of life and worse patient outcomes. Both functional and structural abnormalities of the microcirculation can generate ischemia in the absence of epicardial stenosis or worsen concomitant obstructive coronary artery disease (CAD). The invasive assessment of CMD allows for the evaluation of the entirety of the coronary vascular tree, from the large epicardial vessels to the microcirculation, and enables the study of vasomotor function through vasoreactivity testing. The standard evaluation of CMD includes vasomotor assessment with acetylcholine, as well as flow- and resistance-derived indices calculated with either thermodilution or Doppler guidewires. Tailored treatment based upon the information gathered from the invasive evaluation of CMD has been demonstrated to reduce the burden of angina; therefore, a thorough understanding of these procedures is warranted with the aim of improving the quality of life of the patient. This review summarizes the most widespread approaches for the invasive evaluation of CMD, with a focus on patients with ischemia and nonobstructive CAD.


Item Type:Article
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CRUE-CSIC (Acuerdos Transformativos 2022)

Uncontrolled Keywords:CAD, myocardial ischemia and infarction, microvascular dysfunction, myocardial blood flow
Subjects:Medical sciences > Medicine > Cardiology
ID Code:72904
Deposited On:15 Jun 2022 09:59
Last Modified:15 Jun 2022 10:07

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