CATH CMD is a global algorithm that captures the essential details of performing the bolus thermodilution workflow and assists in decision-making in a simple and stepwise manner. In summary, CATH captures the how to perform bolus thermodilution and CMD captures the what to do with the Coronary Flow Reserve (CFR) and Index of Microcirculatory Resistance (IMR) measurements to provide a diagnosis of Coronary Microvascular Dysfunction (CMD).
A comprehensive physiology assessment (with Resting full-cycle Ratio (RFR), Fractional Flow Reserve (FFR), IMR and CFR) of the epicardial arteries and the microvasculature can provide patients with persistent angina an accurate diagnosis to improve outcomes.1
Kunadian V, et al. EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries. EHJ. 2020; 0, 1-21.
Berry C. Fractional Flow Reserve, Coronary Flow Reserve and the Index of Microvascular Resistance in Clinical Practice. Radcliffe Cardiology. 2014, 1-6.
Fearon W, et al. Invasive Assessment of the Coronary Microvasculature: The Index of Microcirculatory Resistance. Circ Cardiovasc Interv. 2017; 10:e005361
Perera D, et al. Invasive coronary physiology in patients with angina and non-obstructive coronary artery disease. Heart. 2022; 0, 1-8.
Ford T, et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. JACC. 2018, 72, 2841-55.
Ang D, et al. Interventional Diagnostic Procedure: a Practical Guide for the Assessment of Coronary Vascular Function. JOVE 2022; 181, e2265.
Yong A, et al. Calculation of the Index of Microcirculatory Resistance Without Coronary Wedge Pressure Measurement in the Presence of Epicardial Stenosis. JACC: Cardiovasc Interv. 2013; 6, 53-8.
Knuuti J, et al. ESC guidelines. EHJ. 2020; 41, 407-477.
Gulati M, et al. 2021 Chest Pain Guideline, Circulation. 2021; 144, e368-e454.
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