Key result
Hypertensive CMD influences FFR assessment of coronary stenoses though current evidence remains ambiguous.
Why the study?
The influence of hypertensive coronary microvascular dysfunction on the functional significance of coronary artery stenoses assessed by fractional flow reserve remains ambiguous.
How does coronary microvascular dysfunction of hypertensive origin influence the functional significance of coronary artery stenoses measured by FFR?
How does coronary microvascular dysfunction of hypertensive origin influence the functional significance of coronary artery stenoses measured by FFR?
This review highlights the impact of hypertensive coronary microvascular dysfunction on FFR measurements and emphasizes the need for targeted treatments.
May warrant caution interpreting FFR in hypertensive patients; leaves open need for prospective trials to resolve ambiguity.
Arterial hypertension (AH) is currently considered as the main risk factor for the development of atherosclerosis of the epicardial arteries, contributing to the formation of not only structural, but also functional changes in the coronary vessels, including at the level of microcirculation. Aim: To assess the influence of coronary microvascular dysfunction (CMD) of hypertensive origin on the functional significance of stenoses of the main coronary arteries according to measurements of fractional flow reserve (FFR), as well as to analyze the mechanisms of CMD formation in patients with coronary heart disease in combination with hypertension. The FFR measurement method is considered as a standard for making decisions about myocardial revascularization, which can increase the effectiveness of the intervention. However, the results available to date are still ambiguous, as evidenced by the results of numerous meta-analyses presented in the work. Equally important is the assessment of the independent unfavorable prognostic value of CMD, which makes it urgent to develop new targeted treatment methods that reduce the severity of these disorders.
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Mordovin et al. (2024) conducted a review in Coronary heart disease in combination with hypertension. Coronary microvascular dysfunction of hypertensive origin was evaluated on Functional significance of stenoses of the main coronary arteries according to measurements of fractional flow reserve (FFR). Coronary microvascular dysfunction of hypertensive origin influences the functional significance of coronary artery stenoses assessed by fractional flow reserve, though current evidence remains ambiguous.
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