The pathogenic role of coronary microvascular dysfunction in the setting of other cardiac or systemic conditions

Figure 1. Different factors involved in coronary microvascular dysfunction. Dynamic, structural factors, and functional factors contribute to the occurrence of coronary microvascular dysfunction the presence of other conditions. Endothelial dysfunction and vascular smooth muscle cell dysfunction are caused by (often a combination of) structural and/or functional factors. VSMC, vascular smooth muscle cell.

Figure 2. Schematic overview of the pathophysiological mechanisms of coronary microvascular dysfunction in diabetes. Both hyperglycaemia and insulin resistance contribute to oxidative stress, the release of proinflammatory cytokines and the decrease of the nitric oxide availability. cGMP, cyclic guanosine monophosphate; eNOS, endothelial nitric oxide synthase; ICAM-1, intercellular adhesion molecule-1; ILs, interleukins; LDL, low-density lipoprotein; NO, nitric oxide; Ox-LDL, oxidized LDL; PKC, protein kinase C; TNF-α, tumour necrosis factor alpha; VCAM-1, vascular cell adhesion molecule-1.

Figure 3. Schematic overview of the mechanisms involved in the systemic endothelial dysfunction that is present in patients with rheumatic inflammatory diseases, in relation to the occurrence of cardiovascular events. IFN, interferon; IL-2, interleukin-2; PA, psoriatic arthritis; RA, rheumatic arthritis; RFs, risk factors; SLE, systemic lupus erythematosus; SS, systemic sclerosis; TNF, tumour necrosis factor.