Collet Carlos, Yong Andy, Munhoz Daniel, Akasaka Takashi, Berry Colin, Blair John E A, Collison Damien, Engstrøm Thomas, Escaned Javier, Fearon William F, Ford Tom, Gori Tommaso, Koo Bon-Kwon, Low Adrian F, Miner Steve, Ng Martin K C, Mizukami Takuya, Shimokawa Hiroki, Smilowitz Nathaniel R, Sutton Nadia R, Svanerud Johan, Tremmel Jennifer A, Warisawa Takayuki, West Nick E J, Ali Ziad A
Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
Concord Repatriation General Hospital, University of Sydney, New South Wales, Australia.
J Soc Cardiovasc Angiogr Interv. 2024 Apr 3;3(7):101934. doi: 10.1016/j.jscai.2024.101934. eCollection 2024 Jul.
Coronary microvascular dysfunction (CMD) can cause myocardial ischemia in patients presenting with angina without obstructive coronary artery disease (ANOCA). Evaluating for CMD by using the thermodilution technique offers a widely accessible means of assessing microvascular resistance. Through this technique, 2 validated indices, namely coronary flow reserve and the index of microcirculatory resistance, can be computed, facilitating investigation of the coronary microcirculation. The index of microcirculatory resistance specifically estimates minimum achievable microvascular resistance within the coronary microcirculation. We aim to review the bolus thermodilution method, outlining the fundamental steps for conducting measurements and introducing an algorithmic approach (CATH CMD) to systematically evaluate the coronary microcirculation. Embracing a standardized approach, exemplified by the CATH CMD algorithm, will facilitate adoption of this technique and streamline the diagnosis of CMD.
冠状动脉微血管功能障碍（CMD）可导致无阻塞性冠状动脉疾病（ANOCA）的心绞痛患者发生心肌缺血。采用热稀释技术评估CMD提供了一种广泛可用的评估微血管阻力的方法。通过该技术，可以计算出2个经过验证的指标，即冠状动脉血流储备和微循环阻力指数，有助于对冠状动脉微循环进行研究。微循环阻力指数专门用于估计冠状动脉微循环内可达到的最小微血管阻力。我们旨在回顾团注热稀释法，概述进行测量的基本步骤，并介绍一种算法方法（CATH CMD）以系统地评估冠状动脉微循环。采用以CATH CMD算法为代表的标准化方法将有助于该技术的应用，并简化CMD的诊断。
