Invasive Detection of Coronary Microvascular Dysfunction: How It Began, and Where We Are Now

Samer Fawaz; Sarosh Khan; Rupert Simpson; Gerald Clesham; Christopher M Cook; John R Davies; Grigoris V Karamasis; Thomas R Keeble

doi:10.15420/icr.2022.30

Invasive Detection of Coronary Microvascular Dysfunction: How It Began, and Where We Are Now

Interv Cardiol. 2023 Mar 7:18:e07. doi: 10.15420/icr.2022.30. eCollection 2023.

Authors

Samer Fawaz^{1

2}, Sarosh Khan^{1

2}, Rupert Simpson^{1

2}, Gerald Clesham^{1

2}, Christopher M Cook^{1

2}, John R Davies^{1

2}, Grigoris V Karamasis^{2

3}, Thomas R Keeble^{1

2}

Affiliations

¹ Research Department, Roding Ward, Essex Cardiothoracic Centre, Mid and South Essex NHS Hospitals Trust Basildon, UK.
² Department of Circulatory Health Research, Anglia Ruskin University Chelmsford, UK.
³ Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School Athens, Greece.

Abstract

The landscape of interventional cardiology is ever evolving. Contemporary practice has shifted from a stenosis-centred approach to the total characterisation of both the epicardial and microcirculatory vessels. Microcirculatory dysfunction plays an important role in the pathophysiology of acute and chronic coronary syndromes, and characterisation of the microcirculation has important clinical consequences. Accordingly, the invasive diagnosis of microcirculatory dysfunction is becoming a key feature of the interventional cardiologist's toolkit. This review focuses on the methodology underpinning the invasive diagnosis of microvascular dysfunction and highlights the indices that have arisen from these methodologies.

Keywords: Coronary; IMRangio; Rayflow; coronary flow reserve; coronary microcirculation dysfunction; index of microcirculatory circulation; microvascular.

Publication types

Review