Why Does Coronary Microvascular Dysfunction Matter? Up to 50% of patients with chest pain who are referred for cardiac catheterization / coronary angiography do not have obstructive disease of the major coronary arteries. This syndrome is termed ANOCA. Coronary microvascular dysfunction is one of the possible causes (or "endotypes") of ANOCA.
Goals:
Community: Build and identify the community of clinicians dedicated to the diagnosis and management of CMD.
Dialogue: Create forums for knowledge sharing and idea generation based on unmet needs.
Alignment: Develop common language, terminology, approaches around CMD diagnosis and therapy.
Advancement: Advance therapy with research, registries, and guidelines.
Outcomes: Improve access, accurate diagnosis, interpretation, treatment, clinical outcomes and patient quality of life.
Practice Changing Featured Research:
Angiographic Coronary Slow Flow Is Not a Valid Surgate for Invasively Diagnosed Coronary Microvascular Dysfunction. Mayer M, Allan T, Harkin KL, Loftspring E, Saffari SE, Reynolds HR, Paul J, Kalathiya R, Shah AP, Nathan S, McCarthy MC, Smilowitz NR, Miner SES, Blair J. JACC Cardiovasc Interv. 2024 Apr 8;17(7):920-929. doi: 10.1016/j.jcin.2024.02.025. PMID: 38599696
The aim of this study was to investigate relationships between cTFC and invasive CFT for CMD. Coronary slow flow was weakly associated with results of invasive CFT and should not be used as a surrogate for the invasive diagnosis of CMD.
Rethinking False Positive Exercise Electrocardiographic Stress Tests by Assessing Coronary Microvascular Function. Sinha A, Dutta U, Demir OM, De Silva K, Ellis H, Belford S, Ogden M, Li Kam Wa M, Morgan HP, Shah AM, Chiribiri A, Webb AJ, Marber M, Rahman H, Perera D. J Am Coll Cardiol. 2024 Jan 16;83(2):291-299. doi: 10.1016/j.jacc.2023.10.034. PMID: 38199706
In patients with ANOCA, ischemia on EST was highly specific of an underlying ischemic substrate. These findings challenge the traditional belief that EST has a high false positive rate.