Aribas E, Elias-Smale S E, Duncker D J, Piek J J, Ikram M A, Appelman Y, Roeters van Lennep J E, Kavousi M
Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Neth Heart J. 2019 May;27(5):252-262. doi: 10.1007/s12471-019-1274-x.
We aimed to assess the opinion of Dutch cardiologists on coronary microvascular disease (CMD) and its management in clinical practice, and to assess the need for a CMD guideline among Dutch cardiologists.
We developed an online questionnaire including different aspects of CMD which was reviewed by an expert panel. The questionnaire was distributed by e‑mail among all members of the Dutch Society of Cardiology.
A total of 103 cardiologists (70% male) completed the questionnaire (response rate: 10%). Median age and years of experience as a cardiologist were 49 ± 15 and 12 ± 12 years, respectively. Overall, 93% of the cardiologists had considered the CMD diagnosis, 85% had ever made such a diagnosis, 90% had treated a patient with CMD, and 61% had referred patients to tertiary care. The median (interquartile range) self-rated knowledge level was 7.0 (2.0) (scale of 0-10). 84% rated their knowledge as sufficient (>5.5) and 58% viewed CMD as a disease entity. Overall, 61% and 17%, respectively, agreed that evidence-based diagnostic and treatment modalities for CMD do not exist, while 56% believed that CMD patients have a higher risk for cardiovascular disease and mortality. Finally, 82% of the responders stated that a CMD guideline is needed, and 91% wanted to receive the guideline once developed.
Fifty-eight per cent of the responders recognise CMD as a separate disease entity. Our study underscores the need for a dedicated CMD guideline for Dutch cardiology practice. However, the response rate was low (10%), and it is likely that mainly cardiologists interested in CMD have participated in our study.
我们旨在评估荷兰心脏病专家对冠状动脉微血管疾病（CMD）及其临床管理的看法，并评估荷兰心脏病专家对CMD指南的需求。
我们编制了一份涵盖CMD不同方面的在线问卷，并由一个专家小组进行了审核。该问卷通过电子邮件分发给荷兰心脏病学会的所有成员。
共有103名心脏病专家（70%为男性）完成了问卷（回复率：10%）。心脏病专家的中位年龄和从业年限分别为49±15岁和12±12年。总体而言，93%的心脏病专家曾考虑过CMD诊断，85%曾做出过此类诊断，90%曾治疗过CMD患者，61%曾将患者转诊至三级医疗机构。自我评估知识水平的中位数（四分位间距）为7.0（2.0）（0至10分制）。84%的人认为自己的知识足够（>5.5），58%的人将CMD视为一种疾病实体。总体而言，分别有61%和17%的人同意不存在基于证据的CMD诊断和治疗方式，而56%的人认为CMD患者患心血管疾病和死亡的风险更高。最后，82%的受访者表示需要一份CMD指南，91%的人希望一旦指南制定出来就能收到。
58%的受访者将CMD视为一种独立的疾病实体。我们的研究强调了为荷兰心脏病学实践制定专门的CMD指南的必要性。然而，回复率较低（10%），很可能主要是对CMD感兴趣的心脏病专家参与了我们的研究。
