Principles and pitfalls in coronary vasomotor function testing
| Autor: | Robbert J. de Winter, Peter Ong, Laura Bukkems, Patty Teeuwisse, Marcel A.M. Beijk, Udo Sechtem, Rutger Feenstra, Tim van der Hoef, Andreas Seitz, Coen Boerhout, Jan J. Piek, Valérie E. Stegehuis |
|---|---|
| Přispěvatelé: | Cardiology, Graduate School, ACS - Amsterdam Cardiovascular Sciences, Pharmacy, Other Research, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, ACS - Heart failure & arrhythmias, VU University medical center |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Endotype
medicine.medical_specialty stable angina adjunctive pharmacotherapy Functional testing Coronary Artery Disease Coronary Angiography Angina Pectoris Coronary artery disease Angina Clinical Research Humans Medicine Intensive care medicine Protocol (science) Vasomotor function integumentary system ACS/NSTE-ACS business.industry Heart medicine.disease Coronary Vessels miscellaneous Discontinuation Vasomotor System cardiovascular system Thermodilution technique Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | EuroIntervention, 17(15), 1271-1280. EuroPCR EuroIntervention |
| ISSN: | 1774-024X |
| DOI: | 10.4244/eij-d-21-00402 |
| Popis: | BACKGROUND Coronary vasomotor dysfunction can be diagnosed in a large proportion of patients with angina in the presence of non-obstructive coronary artery disease (ANOCA) using comprehensive protocols for coronary vasomotor function testing. Although consensus on diagnostic criteria for endotypes of coronary vasomotor dysfunction have been published, consensus on a standardised study testing protocol is lacking. AIMS In this review we provide an overview of the variations in coronary vasomotor function testing used and discuss the practical principles and pitfalls of coronary vasomotor function testing. METHODS For the purpose of this review we assessed study protocols that evaluate coronary vasomotor response as reported in the literature. We compared these protocols regarding a number of procedural aspects and chose six examples to highlight the differences and uniqueness. RESULTS Currently, numerous protocols co-exist and vary in vascular domains tested, the manner to test these domains (e.g. pre-procedural discontinuation of medication, provocative agent, solution, infusion time, and target artery) and techniques used for measurements (e.g. doppler vs thermodilution technique). CONCLUSIONS This lack of consensus on a uniform functional testing protocol hampers both a broader clinical acceptance of the concepts of coronary vasomotor dysfunction, and the widespread adoption of such testing protocols in current clinical practice. Furthermore, the endotype of coronary vasomotor dysfunction might differ between the few specialised centres that perform coronary vasomotor function testing as a result of the use of different protocols. In this review we provide an overview of the variations in coronary vasomotor function testing used and discuss the practical principles and pitfalls of coronary vasomotor function testing. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|