Coronary microvascular dysfunction is a common pathophysiological denominator across multiple cardiovascular diseases, though specific personalized treatments are currently lacking.
Coronary microvascular dysfunction is a key pathophysiological mechanism across multiple cardiovascular diseases, highlighting the need for further research to develop personalized treatments.
Coronary microvascular dysfunction (CMD) encompasses several pathogenetic mechanisms involving coronary microcirculation and plays a major role in determining myocardial ischemia in patients with angina without obstructive coronary artery disease (CAD), as well as in several other conditions, including obstructive CAD, non-ischemic cardiomyopathies, Takotsubo syndrome and heart failure, especially the phenotype associated with preserved ejection fraction. Unfortunately, despite the identified pathophysiological and prognostic role of CMD in several conditions, to date, there is no specific treatment for CMD. Due to the emerging role of CMD as common denominator in different clinical phenotypes, additional research in this area is warranted in order to provide personalized treatments in this “ garden variety” of patients. The purpose of this review is to describe the pathophysiological mechanisms of CMD and its mechanistic and prognostic role across different cardiovascular diseases. We will also discuss diagnostic modalities and the potential therapeutic strategies resulting from recent clinical studies. Keywords: Coronary microvascular dysfunction, microvascular angina, angina, heart failure, HFpEF, ischemia, MINOCA, INOCA, microcirculation, provocative testing, coronary flow reserve, coronary spasm, ischemic heart disease, coronary flow reserve
Buono et al. (Wed,) conducted a review in Coronary microvascular dysfunction. Coronary microvascular dysfunction is a common pathophysiological denominator across multiple cardiovascular diseases, though specific personalized treatments are currently lacking.