Thread by @CoronaryDoc

#CMD #Tweetorial

⚡ Coronary Microvascular Dysfunction ⚡

1/19

📌 What Is #CMD❓
📌 Why Is #CMD Important❓

Based on my #ACC21 #ACCImaging presentation

2/19
#Tweetorial #CMD #ACC21

Let’s start by talking about angina

✅ Angina w/o obstructive CAD is very prevalent 

🔗ahajournals.org/doi/full/10.11…

3/19
#Tweetorial #CMD #ACC21

✅ Angina ➡ poor prognosis
✅ Angina with no obstructive CAD = ⬆ risks of CV events compared to no angina, even after adjusting for traditional RFs & co-morbidities

🔗academic.oup.com/eurheartj/arti…

4/19
#Tweetorial #CMD #ACC21

✅ Angina ➡ poor prognosis
✅ WISE Study, as compared to asymptomatic women:
Angina + normal coronaries = 3x MACE
Angina + non-obstructive CAD = 6x MACE

@DrMarthaGulati
🔗jamanetwork.com/journals/jamai…

5/19
#Tweetorial #CMD #ACC21

✅ Angina ➡ high socioeconomic burden
✅ #CMD implicated as primary cause of angina in patients w/o obstructive CAD

🔗ahajournals.org/doi/full/10.11…

6/19
#Tweetorial #CMD #ACC21

✅ Epicardial coronaries: primary conductance function w/ minimal resistance to flow under nl conditions
✅ Microcirculation: most of resistance circuit of heart & metabolic regulation of flow in local tissues

@VTaqMD
🔗jacc.org/doi/full/10.10…

7/19
#Tweetorial #CMD #ACC21

#CMD is functional & structural abnormalities of microcirculation resulting in angina + ischemia

8/19
#Tweetorial #CMD #ACC21

#CMD result from:
✅ abnormal vasodilatory ability of microvasculature
✅ compressive external forces affecting intramural microvessels
✅ microvascular spasm

🔗academic.oup.com/cardiovascres/…
🔗nature.com/articles/nrcar…

https://twitter.com/coronarydoc/status/1393721029478998022