Discover and read the best of Twitter Threads about #INOCA

Most recents (8)

📌Parte III. INOCA. Nuevas perspectivas del tto
🔹Agresivo tto de factores de riesgo tradicionales.
🚭Dejar de fumar
🔸Rehabilitación cardiovascular❤️, actividad física aeróbica🏃(140-180m/sem)
#Cardiotwitter #MedTwitter #MINOCA #INOCA
💊Fármacos
✅Fasudil: iRho-Kinase en células musculares lisas y contrala el vasoespasmo (efecto aditivo a nitratos).
✅Denopamine: agonista adrenérgico β1 selectivo x VO:⬆️flujo coronario
✅Medicinas Kempo (hierbas🇯🇵) -reportes-
✅Simpatectomía
⛔️AAS ImageImageImageImage
Read 3 tweets
📌GUIDELINE 2023🇯🇵. Diagnóstico y Tto de Angina Vasoespástica y Disfunción Microvascular Coronaria.
🔸INOCA: Angina y/o isquemia sin lesiones coronarias epicárdicas fijas ≥50% x angio/CT o FFR≤0.8.
🔹≈ 50%👥derivados a angiocoro x angina y/o isquemia👉no tienen lesiones signif ImageImage
📌INOCA
💡Principales mecanismos fisiopatológicos: vasoespasmo epicárdico & disfunción microvascular (⬇️CFR o ⬆️IMR).
🔸Importante superposición entre ambos. ImageImage
📌INOCA. Endotipos y mecanismos de isquemia.
🪸2020 EAPCI expert consensus propone 5⃣endotipos en base a estudios funcionales invasivos coronarios. Image
Read 11 tweets
Patients with #MINOCA were more likely to be women and have fewer traditional CV risk factors. Heterogenous pathophysiology – etiology is of great importance to guide treatment. Inge van den Hoogen #SCCT2021 ImageImageImageImage
#MINOCA diagnosis. Overt non-cardiac disorders need to be excluded. Also need to rule out missed obstruction and non-ischemic causes of myocardial injury. Then after MINOCA diagnosed, need to workup etiology. Inge van den Hoogen #SCCT2021 ImageImageImageImage
Plaque disruption and plaque erosion cause some cases of #MINOCA – diagnose with OCT or IVUS, but not CCTA. Inge van den Hoogen #SCCT2021 ImageImageImage
Read 5 tweets
AGIKplenum: Unverzichtbar im Katheterlabor!?
(Raum 12 @kardiologie_org)

❤️Zweiter Vortrag:
Intravaskuläre Funktionsdiagnostik (Matthias Lutz | @MJLutz | Kiel)

#DGKJahrestagung 2021 @HolgerNef @kaschenke @MarcVorpahl @thiele_holger
Prinzip iFR/FFR etc.

#DGKJahrestagung 2021
Studiendaten (FAME) + Guidelines

#DGKJahrestagung 2021
Read 8 tweets
#Tweetorial on #ASNC2020 session

⚡Selecting Between Different Functional Tests⚡

☢ vs 🧲 vs ⏺ ❓

🔘 Strengths/Limits of Lesion Specific vs Myocardial Ischemia
🔘 Comparing Dx Accuracy of Tests
🔘 Ischemia Testing in #INOCA
🔘 How to Select Best Noninvasive Test

1/9
#ASNC2020 #cvNuc
2/9
Dr Di Carli

☢ Issues with proposed #FFR threshold 0.8
☢ Exercise MPI correlates well with FFR but not at 0.8
☢ Benefit of FFR-guided revasc dominantly occurs w/ thresholds <0.8
☢ Quantification of lesion-specific #ischemia insufficient for patient mgmt
#ASNC2020 #cvNuc
3/9
Dr Di Carli

Lesion-specific #ischemia measurements (FFR/#FFRCT)

☢ Strength
Validated against ETT/MPI
Strong outcome data
Guidelines supported

☢ Limit
Controversial threshold (0.80 vs MPI-validated 0.66)
⬆ microvasc resist causes FFR pseudonormalization
Read 11 tweets
☢ Selecting Between Different Functional Tests in 2020? ☢

This should be most interesting session of virtual #ASNC2020

I am excited to be virtual moderator w/ expert speakers Dan Berman, Keon Nieman, Paul Knaapen, @mdicarli, @VTaqMD

#cvImaging #cvNuc #CardioTwitter ImageImageImage
Are you ready for most exciting #ASNC2020 session?

⚡Selecting Between Different Functional Tests⚡

☢ vs 🧲 vs ⏺ ❓

Let’s hear from #cvImaging giants
Keon Nieman, Paul Knaapen, @mdicarli @VTaqMD @danielbermanmd

📆 Sat, Sept 26
⏰ 2:15 to 3:30PM
🗒 bit.ly/333dRNO ImageImageImageImage
☢ This super exciting session starts in 3 hours ☢

📺 Tune in #cvNuc peeps to learn who benefits from ischemia testing & how to select best non-invasive test

⏰ 2:15 to 3:30PM
#ASNC2020 Image
Read 9 tweets
#SCCT2020 Limitations of Stress Testing/Imaging in Women from @Heart_SCCT
♥️Too few 💃 enrolled in studies based on prevelance esp in CAD and HF
♥️NIH/Gov funded the worst enrollees of women! We need to change that
#scct2020 Sex Considerations for Stress Testing need to be considered
♥️ Sn/Sp of tests based on doing Cath for Obstructive CAD: these are NOT false positives! so these numbers are outdated IMHO
♥️every imaging modality has + &- to consider when imaging women
#SCCT2020
♥️Prognostic implications of CAC in women vs men well established: CAC >300: 💃 do worse
♥️Nonobstructive disease more prevalent in 💃
♥️ Implications on imaging women ultimately
Read 7 tweets
1/7
Very important descriptive study 👇 expanding our understanding of burden of #CMD + endothelial dysfunction in #INOCA (angina) by @TomJFord @ColinBerryMD
@CircIntv

⚡️ Let’s have a short #Tweetorial ⚡️
2/7
Pre-specified analysis of CorMicA
onlinejacc.org/content/72/23_…

Pts undergoing clinically indicated elective coronary angiography for angina & had definite (typical) or probable (atypical) angina based on Rose angina questionnaire

391 pts ➡ angiography:
47% #INOCA
53% #CAD ImageImageImage
3/7
✅ microvascular angina (MVA) = coronary microvascular dysfunction (#CMD) both endothelial independent (CFR/IMR) + endothelial dependent (ACh) (combined)

✅ vasospastic angina (VSA) = epicardial coronary endothelial dysfunction (ACh) ImageImage
Read 8 tweets

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