Key result
Congenital heart disease is frequently associated with coronary microvascular dysfunction across clinical studies.
Why the study?
Coronary microvascular dysfunction in congenital heart disease patients is incompletely understood because studies are rare and heterogeneous, leaving its prevalence, extent, and pathophysiological relevance unclear.
Does congenital heart disease associate with coronary microvascular dysfunction?
Systematic Review
Does congenital heart disease associate with coronary microvascular dysfunction?
Coronary microvascular dysfunction appears to be a common pathophysiological finding in congenital heart disease, similar to other forms of heart failure, warranting further standardized research into its prognostic significance.
Answers are grounded in this paper and cite their sources.
Coronary microvascular dysfunction may warrant evaluation in congenital heart disease; leaves open standardized prognostic assessment pending prospective studies.
Congenital heart diseases represent a wide range of cardiac malformations. Medical and surgical advances have dramatically increased the survival of patients with congenital heart disease, leading to a continuously growing number of children, adolescents, and adults with congenital heart disease. Nevertheless, congenital heart disease patients have a worse prognosis compared to healthy individuals of similar age. There is substantial overlap in the pathophysiology of congenital heart disease and heart failure induced by other etiologies. Among the pathophysiological changes in heart failure, coronary microvascular dysfunction has recently emerged as a crucial modulator of disease initiation and progression. Similarly, coronary microvascular dysfunction could be important in the pathophysiology of congenital heart diseases as well. For this systematic review, studies on maximal vasodilatory capacity in the coronary microvascular bed in patients with congenital heart disease were searched using the PubMed database. To date, coronary microvascular dysfunction in congenital heart disease patients is incompletely understood because studies on this topic are rare and heterogeneous. The prevalence, extent, and pathophysiological relevance of coronary microvascular dysfunction in congenital heart diseases remain to be elucidated. Herein, we discuss what is currently known about coronary microvascular dysfunction in congenital heart disease and future directions. Abstract: Congenital heart diseases represent a wide range of cardiac malformations. Medical and surgical advances have dramatically increased the survival of patients with congenital heart disease, leading to a continuously growing number of children, adolescents, and adults with congenital heart disease. Nevertheless, congenital heart disease patients have a worse prognosis compared to healthy individuals of similar age. There is substantial overlap in the pathophysiology of congenital heart disease and heart failure induced by other etiologies. Among the pathophysiological changes in heart failure, coronary microvascular dysfunction has recently emerged as a crucial modulator of disease initiation and progression. Similarly, coronary microvascular dysfunction could be important in the pathophysiology of congenital heart diseases as well. For this systematic review, studies on maximal vasodilatory capacity in the coronary microvascular bed in patients with congenital heart disease were searched using the PubMed database. To date, coronary microvascular dysfunction in congenital heart disease patients is incompletely understood because studies on this topic are rare and heterogeneous. The prevalence, extent, and pathophysiological relevance of coronary microvascular dysfunction in congenital heart diseases remain to be elucidated. Herein, we discuss what is currently known about coronary microvascular dysfunction in congenital heart disease and future directions.
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Vanreusel et al. (2023) conducted a systematic review in Congenital heart disease. Congenital heart disease vs. Healthy individuals or reference values was evaluated on Coronary microvascular dysfunction (assessed by coronary flow reserve or maximal vasodilatory capacity). A systematic review of 30 papers found that a reduced coronary flow reserve was reported in 20 studies, indicating that coronary microvascular dysfunction is common in patients with congenital heart disease.
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