Why the study?
Coronary microvascular dysfunction causes cardiac complaints, but sex-specific prevalence numbers remain inconclusive and diagnostic approaches may need to account for sex differences.
Key points are not available for this paper at this time.
Design
Review
Knowledge gaps in sex-specific CMD prevalence caution against uniform assumptions; leaves open targeted microvascular studies before practice change.
Sex differences in coronary artery disease (CAD) are well established, with women presenting with non-obstructive CAD more often than men do. However, recent evidence has identified coronary microvascular dysfunction as the underlying cause for cardiac complaints, yet sex-specific prevalence numbers are inconclusive. This review summarises known sex-specific aspects in the pathophysiology of both macro- and microvascular dysfunction and identifies currently existing knowledge gaps. In addition, this review describes current diagnostic approaches and whether these should take underlying sex differences into account by, for example, using different techniques or cut-off values for women and men. Future research into both innovation of imaging techniques and perfusion-related sex differences is needed to fill evidence gaps and enable the implementation of the available knowledge in daily clinical practice.
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Groepenhoff et al. (2019) studied this question.
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