包括的機能評価によって、より患者さんに寄り添う診断を

正確な診断は至適治療に繋がります

冠微小循環障害（CMD）は４つのタイプに分類され、主にはタイプ1の微小循環そのものに異常がある場合を、Microvascular angina（微小血管狭心症）として診療します³。

CFRの正常値は2.0以上ですが、CFR 2.0未満の患者さんは、CFR 2.0以上の方と比較して死亡率およびMACE^※が増加したことが報告されています⁴。

^※MACE：major adverse cardiac event(s)

至適な診断と治療がなければ、心血管イベントの発生リスクにつながる可能性があります⁹。

参照

1. Jespersen, L. et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33:734-744. doi:10.1093/eurheartj/ehr331.
2. Joo Myung Lee, et al. Integrated Physiologic Assessment of Ischemic Heart Disease in Real-World Practice Using Index of Microcirculatory Resistance and Fractional Flow Reserve. Circulation. Nov 2015; 8 (11).
3. Filippo Crea, et al. Coronary microvascular dysfunction: an update. Eur Heart J 35(17): 1101-1111, 2014.
4. Taqueti et al. Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options. JACC 2018.
5. Gautam Kumar, et. al. Real world validation of the nonhyperemic index of coronary artery stenosis severity—Resting full-cycle ratio— RE-VALIDATE. Catheter Cardiovasc Interv. 2019;1–6
6. Tonino et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J. Am. Coll. Cardiol. 2010; 55; 2816-2821
7. Ford, T.J. et al. 1-Year Outcomes of Angina Management Guided by Invasive Coronary Function Testing (CorMicA). J Am Coll Cardiol Intv. 2020;13(1):33-45.
8. Gdowski M, et al. Association of Isolated Coronary Microvascular Dysfunction With Mortality and Major Adverse Cardiac Events: A Systematic Review and Meta-Analysis of Aggregate Data. JAHA. 2020; 9:e014954.
9. Lee, B. et al. Invasive evaluation of patients with angina in the absence of obstructive coronary artery disease. Circulation. 2015;131:1054–1060.