Why the study?
Coronary microvascular disease is associated with adverse cardiovascular outcomes and has a growing prevalence, but guidelines on definitive treatment are lacking.
This review summarizes the current understanding of coronary microvascular disease, including its diagnosis via non-invasive and invasive modalities, and management strategies targeting inflammation and angina.
CMD management remains empirical; leaves open need for standardized diagnostics and RCTs to guide therapy.
Coronary microvascular disease or dysfunction (CMVD) has been associated with adverse cardiovascular outcomes. Despite a growing prevalence, guidelines on definitive treatment are lacking. Proposed mechanisms of endothelial dysfunction and resultant inflammation have been demonstrated as the underlying cause. Imaging modalities such as echocardiography, cardiac MRI, PET, and in some instances CT, have been shown to be useful in diagnosing CMVD mainly through assessment of coronary blood flow. Invasive measurements through thermodilution and pressure sensor-guided Doppler microcatheters have also been utilized. Treatment options are directed at targeting inflammatory pathways and angina. In our review, we highlight the current literature on the background of CMVD, diagnostic modalities, and management of this disease.
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Thakker et al. (2022) studied this question.
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