Defining Population at Risk and Assessment of Patients With Presumed Coronary Microvascular and Vasomotor Dysfunction

The societal burden and prognostic relevance of coronary microvascular and vasomotor dysfunction are well established, but there are currently limited therapies proven to improve clinical outcomes of these patients. This may be explained by the heterogeneity of the population and the complexity of the underlying pathophysiology. In this first companion paper, we revisit clinical conditions and patient groups at risk for coronary microvascular and vasomotor dysfunction, identify non-invasive tests of peripheral and coronary vascular function that may be helpful for baseline assessment and long-term follow-up, define the metrics of disease burden that might determine the need for invasive assessment and serve as outcome measures. We use these observations to define the baseline and follow-up variables that will be included in the Canadian Coronary Physiology Registry. When integrated with invasive metrics derived from a standardized invasive coronary function testing protocol, it will ultimately facilitate the design and conduct of future clinical outcomes trials in Canada.