Dysfunction of the heart’s microvascular system is increasingly being seen as a possible source of angina in patients with little or no disease in their main coronary arteries. However, the causes are not yet well understood as there are several potential mechanisms involved, such as vasospasm or endothelial disease. In addition, many centres do not currently routinely test microvascular function, leaving symptomatic patients without an adequate diagnosis. For those patients who are diagnosed as having microvascular disorders, treatment strategies remain imprecise.
The NIHR and BHF Workstream is a collaboration between a growing number of UK hospitals and universities which aims to improve outcomes for patients with coronary microvascular dysfunction. We aim to do this by improving diagnosis and understanding of CMD through standardisation of invasive and non-invasive techniques, encouraging multicentre research and clinical trials and promoting collaboration with industry partners.
We aim to encourage greater understanding of CMD and adoption of testing techniques nationally, to improve patient outcomes and service provision. To do this a series of standard operating procedures have been developed for invasive, cardiac catheter laboratory testing and also non-invasive cardiac MRI testing.