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Principles and pitfalls in coronary vasomotor function testing.

Rutger G T Feenstra1, Andreas Seitz2, Coen K M Boerhout1

  • 1Department of Clinical and Experimental Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|July 19, 2021
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Summary
This summary is machine-generated.

Standardizing coronary vasomotor function testing (CFT) protocols is crucial for diagnosing coronary vasomotor dysfunction in angina patients with non-obstructive coronary artery disease. Current variations hinder clinical acceptance and widespread adoption of these vital tests.

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Area of Science:

  • Cardiology
  • Vascular Physiology

Background:

  • Coronary vasomotor dysfunction is prevalent in patients with angina and non-obstructive coronary artery disease (ANOCA).
  • While diagnostic criteria for endotypes exist, a standardized coronary vasomotor function testing (CFT) protocol is lacking.

Purpose of the Study:

  • To review variations in current CFT protocols.
  • To discuss practical principles and potential pitfalls of CFT.

Main Methods:

  • Literature review of study protocols evaluating coronary vasomotor response.
  • Comparison of protocols based on procedural aspects.
  • Selection of six diverse protocols for detailed analysis.

Main Results:

  • Numerous CFT protocols exist with variations in vascular domains tested.
  • Differences observed in medication management, provocative agents, solutions, infusion times, and target arteries.
  • Variations noted in measurement techniques, including Doppler and thermodilution.

Conclusions:

  • Lack of a uniform CFT protocol impedes clinical acceptance and adoption of coronary vasomotor dysfunction testing.
  • Divergent protocols may lead to differing endotype characterization across specialized centers.
  • Standardization is essential for consistent diagnosis and management of coronary vasomotor dysfunction.