Key result
Coronary microvascular dysfunction linked to lower GLS and higher LAVI, suggesting early LV involvement.
Why the study?
Coronary microvascular dysfunction contributes to myocardial ischemia and adverse cardiovascular outcomes, but its association with impairment in LV systolic and diastolic function remained unclear.
Is coronary microvascular dysfunction associated with impairment in left ventricular systolic and diastolic parameters compared to controls?
Meta-Analysis
Is coronary microvascular dysfunction associated with impairment in left ventricular systolic and diastolic parameters compared to controls?
Coronary microvascular dysfunction is associated with early signs of left ventricular involvement, specifically lower global longitudinal strain and higher left atrial volume index, despite preserved LVEF.
Answers are grounded in this paper and cite their sources.
Questions the role of CMD in LV diastolic impairment; leaves open its influence on systolic function and prognosis.
OBJECTIVES: Coronary microvascular dysfunction (CMD) has been increasingly acknowledged as an important contributor to myocardial ischemia and unfavorable cardiovascular outcomes. However, whether CMD is associated with impairment in left ventricular (LV) systolic and diastolic function remains unclear. This systematic review and meta-analysis aimed to assess differences in LV systolic and diastolic parameters between patients with CMD and controls. METHODS: A systematic search was conducted on PubMed, Embase, and Web of Science for observational studies reporting LV systolic and diastolic parameters in patients with CMD and controls. Pooled analyses were performed for GLS, GCS, GRS, LVEF, LAVI, E/A, E', and E/E' using random-effects models. No significant differences were identified in E/A or E'. CONCLUSION: CMD was associated, on average, with lower GLS and higher LAVI, whereas E/E' tended to be higher but remained non-significant, with confidence intervals including the null and considerable between-study heterogeneity. These findings may provide supportive evidence of early LV involvement in patients with CMD despite preserved LVEF, although the GLS result should be interpreted cautiously given the marked heterogeneity.
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Wang et al. (2026) conducted a meta-analysis in Coronary microvascular dysfunction. Coronary microvascular dysfunction vs. Controls was evaluated on LV systolic and diastolic parameters (GLS, GCS, GRS, LVEF, LAVI, E/A, E', and E/E'). Coronary microvascular dysfunction was associated with lower global longitudinal strain and higher left atrial volume index compared to controls, suggesting early left ventricular involvement.
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