Key result
The CATH CMD algorithm provides a standardized approach using bolus thermodilution to systematically evaluate the coronary microcirculation and streamline the diagnosis of microvascular dysfunction.
Why the study?
Coronary microvascular dysfunction can cause myocardial ischemia in patients with ANOCA, motivating a review of bolus thermodilution and a standardized algorithmic approach (CATH CMD) to systematically evaluate the coronary microcirculation.
The CATH CMD algorithm provides a standardized approach to evaluating coronary microvascular dysfunction using bolus thermodilution, facilitating its adoption and streamlining diagnosis in the cath lab.
May aid standardized CMD diagnosis; leaves open prospective validation of bolus thermodilution algorithms.
Coronary microvascular dysfunction (CMD) can cause myocardial ischemia in patients presenting with angina without obstructive coronary artery disease (ANOCA). Evaluating for CMD by using the thermodilution technique offers a widely accessible means of assessing microvascular resistance. Through this technique, 2 validated indices, namely coronary flow reserve and the index of microcirculatory resistance, can be computed, facilitating investigation of the coronary microcirculation. The index of microcirculatory resistance specifically estimates minimum achievable microvascular resistance within the coronary microcirculation. We aim to review the bolus thermodilution method, outlining the fundamental steps for conducting measurements and introducing an algorithmic approach (CATH CMD) to systematically evaluate the coronary microcirculation. Embracing a standardized approach, exemplified by the CATH CMD algorithm, will facilitate adoption of this technique and streamline the diagnosis of CMD.
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Collet et al. (2024) conducted a review in Coronary microvascular dysfunction (CMD) in patients with angina without obstructive coronary artery disease (ANOCA). Bolus thermodilution method (CATH CMD algorithm) was evaluated. The CATH CMD algorithm provides a standardized approach using bolus thermodilution to systematically evaluate the coronary microcirculation and streamline the diagnosis of microvascular dysfunction.
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