Diagnosis of patients with angina and non-obstructive coronary disease in the catheter laboratory

Heart
Haseeb RahmanDivaka Perera

Abstract

Around 40% of all patients undergoing angiography are found to have normal coronary arteries or non-obstructive coronary artery disease (NOCAD). Despite the high prevalence, this is a group who rarely receive a definitive diagnosis, are frequently labelled and managed inappropriately and by and large, continue to remain symptomatic. Half of this group will have coronary microvascular dysfunction (CMD), associated with a higher rate of major adverse cardiovascular events; identifying CMD represents a therapeutic target of unmet need. As the pressure wire has revolutionised our ability to interrogate epicardial coronary disease during the time of angiography, measuring flow can similarly classify NOCAD during a single procedure. Assessment of flow is a function that is already integral to some pressure wires and furthermore, the familiarity and usage of the combined Doppler and pressure wire is rapidly increasing-these are techniques that readily lend themselves to the skillset of a practising interventional cardiologist. We present a structured algorithm designed for cardiologists who frequently encounter NOCAD in the catheter laboratory, identifying specific disease phenotypes within this heterogeneous population with linked th...Continue Reading

References

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Citations

Feb 8, 2020·European Heart Journal. Acute Cardiovascular Care·Christiaan Jm Vrints
Feb 15, 2020·Heart·Thomas Joseph Ford, Colin Berry
Jun 11, 2020·Circulation. Cardiovascular Interventions·Haseeb RahmanDivaka Perera
Jun 12, 2020·Heart·Stephen P Hoole, Paul Bambrough
Sep 10, 2020·Journal of Clinical Medicine·Federico VancheriMichael Henein
Jul 7, 2020·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Vijay KunadianAndreas Baumbach
Feb 27, 2021·Cardiovascular Endocrinology & Metabolism·Aish SinhaDivaka Perera
Feb 23, 2021·JRSM Cardiovascular Disease·Bhavik Modi, Divaka Perera
Apr 9, 2021·Angiology·Michael Y Henein, Federico Vancheri
Jun 22, 2021·Clinical Hemorheology and Microcirculation·Camillo L C JunqueiraEliete Bouskela
Jul 1, 2021·Journal of the American Heart Association·Muhammad Aetesam-Ur-RahmanStephen P Hoole

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Methods Mentioned

BETA
cognitive behavioural therapy

Software Mentioned

CorMicA
COVADIS
NOCAD
DEFINE Flow

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