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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Current perspectives in coronary microvascular dysfunction.

Joy S Shome1, Divaka Perera2, Sven Plein1,3

  • 1Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St. Thomas' Hospital, London, UK.

Microcirculation (New York, N.Y. : 1994)
|December 16, 2016
PubMed
Summary
This summary is machine-generated.

Coronary microvascular dysfunction (CMD) affects women disproportionately, presenting with ischemia despite clear arteries. Advanced imaging like cardiac MRI and PET are crucial for diagnosing CMD and assessing coronary microvascular function.

Keywords:
microvascular ischemia

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • The coronary arterial system, including epicardial arteries and microcirculation, regulates coronary blood flow (CBF).
  • Coronary microvascular dysfunction (CMD) arises from microcirculation abnormalities and can mimic obstructive coronary artery disease (CAD).
  • CMD often presents with ischemic symptoms in women, even without significant epicardial CAD.

Purpose of the Study:

  • To highlight the prevalence and clinical presentation of CMD, particularly in women.
  • To discuss the limitations of conventional angiography in visualizing the microcirculation.
  • To emphasize the role of advanced imaging in assessing coronary microvascular function.

Main Methods:

  • Utilizing invasive indices like CBF and CFR.
  • Employing non-invasive imaging modalities such as cardiac MRI (CMR) and Positron Emission Tomography (PET).
  • Quantifying absolute myocardial blood flow (MBF) for accurate assessment.

Main Results:

  • CMD can present with symptoms suggestive of obstructive CAD but without significant epicardial lesions.
  • CMR and PET enable direct and accurate assessment of coronary microvascular function.
  • CMD is more prevalent in women and has a less favorable prognosis.

Conclusions:

  • CMD diagnosis and evaluation require methods beyond conventional angiography.
  • Cardiac MRI and PET are essential tools for evaluating suspected CMD.
  • Understanding CMD mechanisms requires further investigation, though imaging aids detection.