Definition and epidemiology of coronary microvascular disease

Bradley, Conor; Berry, Colin

doi:10.1007/s12350-022-02974-x

Cited by 32 publications

(11 citation statements)

References 68 publications

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“…CAD affects larger epicardial arteries (>500 µm), while CMVD affects smaller ones (<500 µm). CMVD exists in a large proportion of patients with IHD and/or other cardiovascular diseases, and it may or may not co-exist with CAD [24]. IMBV could serve as a novel index for micro-vascular function to diagnose CMVD independent of CAD.…”

Section: Discussionmentioning

confidence: 99%

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Segmentation-free PVC for Cardiac SPECT using a Densely-connected Multi-dimensional Dynamic Network

Xie,

Liu,

Shi

et al. 2022

Preprint

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In nuclear imaging, limited resolution causes partial volume effects (PVEs) that affect image sharpness and quantitative accuracy. Partial volume correction (PVC) methods incorporating high-resolution anatomical information from CT or MRI have been demonstrated to be effective. However, such anatomical-guided methods typically require tedious image registration and segmentation steps. Accurately segmented organ templates are also hard to obtain, particularly in cardiac SPECT imaging, due to the lack of hybrid SPECT/CT scanners with high-end CT and associated motion artifacts. Slight mis-registration/missegmentation would result in severe degradation in image quality after PVC. In this work, we develop a deeplearning-based method for fast cardiac SPECT PVC without anatomical information and associated organ segmentation. The proposed network involves a densely-connected multi-dimensional dynamic mechanism, allowing the convolutional kernels to be adapted based on the input images, even after the network is fully trained. Intramyocardial blood volume (IMBV) is introduced as an additional clinical-relevant loss function for network optimization. The proposed network demonstrated promising performance on 28 canine studies acquired on a GE Discovery NM/CT 570c dedicated cardiac SPECT scanner with a 64-slice CT using Technetium-99m-labeled red blood cells. This work showed that the proposed network with densely-connected dynamic mechanism produced superior results compared with the same network without such mechanism. Results also showed that the proposed network without anatomical information could produce images with statistically comparable IMBV measurements to the images generated by anatomical-guided PVC methods, which could be helpful in clinical translation.

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Section: Discussionmentioning

confidence: 99%

“…Coronary microvascular disease (CMVD) is a prevalent and critical global health problem, which is often unrecognized [24]. Non-invasive methods to evaluate myocardial microcirculatory function to accurately diagnose CMVD remains complicated and time consuming.…”

Section: Introductionmentioning

confidence: 99%

Segmentation-free PVC for Cardiac SPECT using a Densely-connected Multi-dimensional Dynamic Network

Xie,

Liu,

Shi

et al. 2022

Preprint

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“…(Figure 12A-H) Clinically, a majority of patients performed noninvasive computed tomography coronary angiograms (CTA) or invasive coronary angiograms for angina investigation lack obstructive coronary artery disease (Patel et al, 2010). Approximately two in five referred patients receive a primary CMVD diagnosis (Bradley and Berry, 2022) (Liu et al, 2021), (Ding et al, 2021).…”

Section: Modulation Of No and Et-1 In Ogd Model Cells By Sxdpmentioning

confidence: 99%

Exploration of the effect and mechanism of Shexiang Tongxin Dropping Pill on coronary microvascular dysfunction

LI,

Xuan,

et al. 2024

Preprint

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Coronary microvascular dysfunction(CMVD) refers to a clinical syndrome of myocardial ischemia caused by abnormal microvascular structure or function of coronary arteries with a diameter less than 500µm.It is closely related to adverse cardiovascular events,and its treatment remains a clinical challenge. Shexiang Tongxin Dropping Pill(SXDP) shows the effect of improving coronary microvascular perfusion, but the underlying mechanism remains largely unclear.In this study,we aims to observe the effects of SXDP on enhancing coronary blood flow in coronary artery disease(CAD) patients undergoing percutaneous coronary intervention (PCI) treatment and coronary microvascular embolism(CME) mice model while investigating potential mechanisms linked to oxidative stress and inflammatory responses.Firstly, we selected 62 patients with angina pectoris who were negative for cardiac troponin and randomly divided them into control group and SXDP group, with 31 cases in each group. The control group was given aspirin, statin, ACEI, and β-receptor blocker, the SXDP group added the SXDP on the basis of the above drugs. Both groups took the medicine for three consecutive days, coronary angiography(CAG) and(or) PCI were performed on the the fourth day,two hours before surgery, the control group received 300mg of aspirin and 300mg of clopidogrel, while the SXDP group received 10 pills of SXDP in addition to the aforementioned medication, Subsequently implemented CAG to observe the corrected TIMI frame count(CTFC) value of coronary blood flow, as well as the TC, LDL-C, Lp-PLA2,FIB and hs-CRP in serum. Secondly,we utilized electrocardiogram recordings, laser speckle imaging, and histological examination to assess the enhancement of coronary blood flow in CME mice model induced by autologous blood clot particles following SXDP treatment. Additionally, an in vitro model of oxygen-glucose deprivation (OGD) was established using human umbilical vein endothelial cells(HUVECs) to investigate the impact of SXDP on lncRNA H19 and P66shc DNA methylation. In clinical trials, we observed that SXDP can increase coronary CTFC values and reduce the serum levels of TC, LDL-C, Lp-PLA2, FIB and hs- CRP to varying degrees.And in the CME mice model, SXDP was found to enhance myocardial blood supply, decrease thrombosis and myocardial micro- infarctions, and improve coronary microvascular endothelial function. In vitro experiments, we observed SXDP enhances p66shc DNA methylation through the inhibition of lncRNAH19 expression, leading to a reduction in oxidative stress and inflammatory responses in coronary microvessels. Our findings suggested that SXDP can effectively improve coronary microvascular blood flow in patients with CAD and CME model mice,Simultaneously, lncRNAH19 is a key molecule in SXDP's regulation of P66shc,we should focus on lncRNAH19 as potential values for evaluating CMVD.

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“…The absence of universally accepted guidelines to diagnose CMD makes it challenging for healthcare practitioners to consistently recognise and differentiate it from other cardiac conditions. This lack of standardised criteria also hampers research efforts and makes it difficult to compare findings across studies [ 13 ].…”

Section: Reviewmentioning

confidence: 99%

Unveiling the Enigma: Exploring the Intricate Link Between Coronary Microvascular Dysfunction and Takotsubo Cardiomyopathy

Datta,

Nath,

Pathade

et al. 2023

Cureus

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This review article delves into the intricate and evolving relationship between coronary microvascular dysfunction (CMD) and takotsubo cardiomyopathy (TCM), two intriguing cardiovascular conditions increasingly recognised for their potential interplay. We examine their characteristics, shared pathophysiological mechanisms, diagnostic challenges, and management strategies. Emerging evidence suggests a link between microvascular dysfunction and the development of TCM, leading to a deeper exploration of their connection. Accurate diagnosis of both conditions becomes essential, as microvascular dysfunction may modify TCM outcomes. We underscore the significance of understanding this connection for improved patient care, emphasising the need for tailored interventions when CMD and TCM coexist. Collaborative research and heightened clinical awareness are advocated to advance our comprehension of this relationship. Through interdisciplinary efforts, we aim to refine diagnostic precision, develop targeted therapies, and enhance patient outcomes in cardiovascular medicine.

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Definition and epidemiology of coronary microvascular disease

Cited by 32 publications

References 68 publications

Segmentation-free PVC for Cardiac SPECT using a Densely-connected Multi-dimensional Dynamic Network

Segmentation-free PVC for Cardiac SPECT using a Densely-connected Multi-dimensional Dynamic Network

Exploration of the effect and mechanism of Shexiang Tongxin Dropping Pill on coronary microvascular dysfunction

Unveiling the Enigma: Exploring the Intricate Link Between Coronary Microvascular Dysfunction and Takotsubo Cardiomyopathy

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