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🏴‍☠️CMD-HFpEF is a prevalent endotype of HFpEF ❌However, its pathophysiology remains incompletely understood ✅We discuss impaired lusitropy and subendocardial ischemia as the potential link between CMD and HFpEF bit.ly/3Pu66ro

ChaMP-CMD trial results just published in Circulation Aish Sinha Divaka Perera Medical Research Council Cardiovascular and Metabolic Medicine & Sciences ➡️ Patients with CMD (low CFR) benefit from anti-ischaemic therapy but not those with a normal CFR ➡️ CFR establishes diagnosis AND guides treatment. doi.org/10.1161/CIRCUL…

Do Myocardial Bridges Cause Ischemia? Characterising Mechanisms of Ischemia in Patients with Myocardial Bridges. A simultaneous publication to AHAMeetings #AHA2023. ahajournals.org/doi/abs/10.116… Divaka Perera Aish Sinha Haseeb Rahman @Ukheartresearch AHA Science @circAHA

➡️Rethinking False Positive ETT by Assessing Coronary Microvascular Function. 🎯In patients with ANOCA, ischemia on ETT was highly specific of an underlying ischemic substrate. 🎯Comprehensive coronary physiology 🔗jacc.org/doi/10.1016/j.… BCIS PCRonline 🫀 JACC Journals

#ICYMI #OriginalResearch: In the #ChaMP-CMD trial of ANOCA patients, invasive CFR suggestive of coronary microvascular disease identified patients who derived greater response to anti-ischemic therapy Divaka Perera Ozan M. Demir Amedeo Chiribiri #AHAJournals

In patients with #ANOCA, ischemia during exercise #ECG stress testing was highly specific for coronary microvascular dysfunction bit.ly/41TKydp #JACC Aish Sinha Haseeb Rahman Divaka Perera Cardiac Research

The authors of a recent study published in #JACC conclude that in patients w/ ANOCA, ischemia on EST is highly specific of an underlying ischemic substrate. These findings challenge the traditional belief that EST has a high false positive rate. bit.ly/3vv9ifS

Rethinking false positive exercise electrocardiographic stress tests by assessing coronary microvascular function This study aims to compare the results of EST in patients reporting #angina with those having non-obstructive coronary artery disease (#ANOCA), against the reference

💥When assessed against the reference standard of comprehensive coronary physiology, ischemia on EST had 100% specificity for an underlying vasomotor disorder. 💥These findings challenge the current dogma and may lead to a paradigm shift in the evaluation of patients with CCS.

Rationale and design of the CHIP-BCIS3 randomized controlled trial: LV unloading in high-risk PCI. Just published in Circ CVINT. ➡️ historical challenges of trials in MCS ➡️innovative design and ideal population to deliver a definitive trial bit.ly/4bV3VHu

HFpEF is a growing healthcare burden, and CMD is prevalent among sufferers. We discuss this association + the gaps in evidence in our review in AHJ+: 🫀CMD as part of the pro-inflammatory paradigm in HFpEF. ➡️CMD as a pathophysiological driver. bit.ly/CMD-HFpEF

Really interesting results and external validation of previous work by #KCL team. 🔗ahajournals.org/doi/10.1161/JA… ➡️Coronary slow flow not associated with abnormal CFR or microvascular resistance. Divaka Perera Haseeb Rahman Aish Sinha Cardiac Research

🔬 Microvascular Resistance Reserve (MRR) is a novel physiological index that is specific to the microcirculation. ✅ We report the MRR thresholds that predict ischemia on CMR (diagnostic) and response to the anti-ischemic therapy (therapeutic). bit.ly/3AW2hHM

Accuracy of PW–Derived Indices in LMCA Disease JACC Journals 🔗 authors.elsevier.com/a/1kPI16uPJvuW… ➡️FFR superior to NHPRs at detecting significant LMCA disease ➡️Discordance rates: iFR 18.1% and Pd/Pa 17.0%, primarily due to false negatives British Heart Foundation Cardiovascular and Metabolic Medicine & Sciences PCRonline 🫀 American College of Cardiology

Pressure-Derived Indices in Left Main Coronary Artery Disease CircInterventions ➡️ PW indices differ significantly between the LAD and LCx in isolated LMCA due to inherent differences in microvascular resistance and coronary flow. 🔗ahajournals.org/doi/10.1161/CI… British Heart Foundation Cardiovascular and Metabolic Medicine & Sciences

📰tctmd.com/news/pressure-… 🔗ahajournals.org/doi/full/10.11… ⁉️ Should diagnostic thresholds for FFR, iFR, CFR be specific to each vessel. TCTMD Caitlin E. Cox CircInterventions Sunil V. Rao William Fearon Mamas A. Mamas Gregg W. Stone MD John Mandrola, MD curzen Rasha Al-Lamee Dr Shrilla Banerjee MD FRCP 💙 Giuseppe Biondi-Zoccai Javier Escaned

Registration is OPEN for #INOCA2025! 🗓️ 25–26 Sept | 📍 London Join Divaka Perera and Amedeo Chiribiri, for two days of cutting-edge insights into Coronary Microvascular Dysfunction. ✅ Live cases ✅ Patient stories ✅ Tech & trials ✅ Real-world clinical tools Register here:

Everything you wanted to know about INOCA in 2 days! Well worth registering asap for #INOCA2025, a British Heart Foundation - National Institute for Health and Care Research CV partnership meeting. Stellar international faculty, guideline updates, how to sessions, debates, breaking research, discussion, live cases and more!

🔑 We recommend using adenosine, dobutamine & ACh for full MB phenotyping in the cath lab 🔑 bit.ly/3TnnY9y Javier Escaned Viviany Taqueti Carlos Collet MD PhD Ritu Thamman MD Professor Vijay Kunadian William Fearon Habib Samady Janet Wei MD samitshahmd Michel T. Corban, MD Rajiv Gulati Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦

ICYMI: Registration is open for #INOCA2025, bringing together clinicians, researchers, patients and industry experts to share insights and foster collaboration💚 🗓️25-26 Sept | 📍London Institute for Healthcare Engineering 🔍An in-depth look at coronary microvascular