TY  - BOOK
AU  - Banerjee, AvantikabMHVI
AU  - Ben-Dor, Itsik
AU  - Case, Brian C
AU  - Cellamare, Matteo
AU  - Hashim, Hayder
AU  - Lopez, KassandrabMHVI
AU  - Merdler, Ilan
AU  - Ozturk, Sevket Tolga
AU  - Reddy, Pavan
AU  - Sawant, Vaishnavi
AU  - Waksman, Ron
AU  - Wallace, Ryan
AU  - Zhang, Cheng
TI  - Coronary microvascular dysfunction assessment: A comparative analysis of procedural aspects
SN  - 1522-1946
PY  - 2024///
KW  - *Coronary Artery Disease
KW  - *Microvascular Angina
KW  - *Myocardial Infarction
KW  - *Myocardial Ischemia
KW  - Aged
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Artery Disease/th [Therapy]
KW  - Coronary Circulation
KW  - Coronary Vessels/dg [Diagnostic Imaging]
KW  - Female
KW  - Humans
KW  - Male
KW  - Microcirculation
KW  - Microvascular Angina/di [Diagnosis]
KW  - Middle Aged
KW  - Treatment Outcome
KW  - Automated
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Advanced Cardiac Catheterization Research Fellowship
KW  - Cardiovascular Disease Fellowship
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - BACKGROUND: Full adoption of coronary microvascular dysfunction (CMD) assessment faces challenges due to its invasive nature and concerns about prolonged procedure time and increased contrast and/or radiation exposure. We compared procedural aspects of CMD invasive assessment to diagnostic left heart catheterization (DLHC) in patients with chest pain who were not found to have obstructive coronary artery disease; CONCLUSION: Compared to DLHC, CMD assessment is safe and requires only slightly additional contrast use (10 mL) and slightly longer fluoroscopy time (2 min) without clinical implications. These findings emphasize the favorable safety and feasibility of invasive CMD assessment. Copyright © 2024 Wiley Periodicals LLC; METHODS: A total of 227 patients in the Coronary Microvascular Disease Registry were compared to 1592 patients who underwent DLHC from August 2021 to November 2023. The two cohorts were compared using propensity-score matching; primary outcomes were fluoroscopy time and total contrast use; RESULTS: The participants' mean age was 64.1 +/- 12.6 years. CMD-assessed patients were more likely to be female (66.5% vs. 45.2%, p < 0.001) and have hypertension (80.2% vs. 44.5%, p < 0.001), history of stroke (11.9% vs. 6.3%, p = 0.002), and history of myocardial infarction (20.3% vs. 7.7%, p < 0.001). CMD assessment was safe, without any reported adverse outcomes. A propensity-matched analysis showed that patients who underwent CMD assessment had slightly higher median contrast exposure (50 vs. 40 mL, p < 0.001), and slightly longer fluoroscopy time (6.9 vs. 4.7 min, p < 0.001). However, there was no difference in radiation dose (209.3 vs. 219 mGy, p = 0.58) and overall procedure time (31 vs. 29 min, p = 0.37)
UR  - https://dx.doi.org/10.1002/ccd.30990
ER  -