Measuring Microvasculature with Dr. Nick West

Dr. Nick West, Chief Medical Officer and Divisional Vice President of Global Medical Affairs, Abbott Vascular at Abbot joins the show to discuss his research on coronary microvascular dysfunction (CMD). In this episode, you'll discover:

• Where your heart receives its blood supply, and how the answer could lead to a potentially lethal underlying condition affecting almost half of those who suffer from angina (chest pain caused by reduced blood flow to the heart)
• In what way a temperature sensor plays a critical role in the diagnosis of microvasculature malfunction
• What could explain why many patients continue to suffer from chest pain even after the placement of a cardiac stent or cardiac bypass surgery

About 90% of the heart's blood supply is delivered by the coronary microvasculature, which is composed of tiny vessels 10 to 50 microns in diameter. This leaves just 10% of the blood supply to the three main, large arteries of the heart. Surprisingly, much of the focus in the field of research on coronary health and disease has revolved around the large arteries, and overlooked the importance of the heart's microvasculature.

The vessels that make up the coronary microvasculature are too small to be detected on coronary angiogram. Dr West explains how this could account for the fact that about 50% of the patients who end up in a cardiac catheter lab with a presumptive diagnosis of angina don't walk away with a surgical recommendation. In other words, if the typical narrowing of the larger coronary vessels can't be identified, then a patient will be told not to worry, and that a surgical procedure (such as a stent or bypass) isn't necessary.

In reality, it's possible that many of these patients suffer from microvascular dysfunction. With the real problem flying under the radar, these patients are left with no way to get better. As a result, they suffer poor quality of life, present recurrently to ERs and specialists, undergo extensive testing to no avail, and are at higher risk of heart attack and death.

Dr. West wants to know how microvascular dysfunction can be diagnosed, and whether a treatment can be developed. Essential to diagnosing it is a tool called a pressure wire, which is used to measure the pressure gradient across the coronary artery. There are several on the market, but none like the one Dr. West has helped develop; it has a temperature sensor, which allows for thermodilution tests to be performed. This test measures the time it takes for a room-temperature bolus of saline to reach the temperature sensor on the pressure wire from the top of the coronary artery. The tighter the microvascular circulation, the longer it will take for the bolus to reach the sensor.

Tune in to hear Dr. West explain all of this and more. Find further information and read the white paper at https://www.cardiovascular.abbott/us/en/campaigns/beyond-intervention.html. Dr. West's blog: https://www.linkedin.com/posts/ugcPost-6683355388731027456-BgEu/ that announces the launch of Coroventis. The full report and announcement of the recently launched "Beyond Intervention" global research.

New Research Finds Physicians and Patients Point to Emerging Technology and Data as Central to Closing Treatment Gaps and Improving Vascular Health

• New research found physicians and patients agree that there are widening gaps in vascular disease treatment[ii]
• 55% of physicians from nine countries around the globe say the shortage of time to spend with each patient is the biggest challenge to improving the patient experience and delivering better outcomes
• 72% of patients want more personalized care
• More than 80% of physicians and more than 90% of hospital administrators agree that advances in diagnostic and treatment technologies have led to tangible improvements in patient care

Available on Apple Podcasts: apple.co/2Os0myK