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Coronary microvascular dysfunction: an update

Filippo Crea1, Paolo G Camici, Cathleen Noel Bairey Merz

  • 1Department of Cardiovascular Sciences, Institute of Cardiology, Catholic University of the Sacred Heart, 00187 L.go Vito 1, Roma, Italy.

European Heart Journal
|December 25, 2013
PubMed

Insights

Coronary microvascular dysfunction (CMD) affects patients with and without obstructive coronary artery disease. Understanding CMD

Area of Science:

  • Cardiology
  • Vascular Biology
  • Internal Medicine

Background:

  • Many patients with chest pain have normal coronary angiograms, suggesting non-obstructive causes.
  • Coronary microvascular dysfunction (CMD) is increasingly recognized in various cardiovascular conditions.
  • CMD can be associated with risk factors, myocardial diseases, and even obstructive atherosclerosis.

Purpose of the Study:

  • To review the clinical relevance of coronary microvascular dysfunction (CMD) in diverse patient populations.
  • To discuss the implications of CMD for cardiovascular and myocardial disease pathogenesis.
  • To highlight the therapeutic potential of addressing CMD.

Main Methods:

  • This review synthesizes current research on coronary microvascular dysfunction.
  • It examines studies investigating CMD in patients with and without obstructive coronary artery disease.
  • The review considers iatrogenic causes and the role of CMD as a risk marker.

Main Results:

  • Coronary microvascular dysfunction (CMD) is prevalent in patients with chest pain syndromes and normal coronary angiograms.
  • CMD can be an epiphenomenon or a significant contributor to cardiovascular disease development.
  • Abnormalities in coronary microcirculation structure and function are linked to risk factors and myocardial diseases.

Conclusions:

  • Coronary microvascular dysfunction (CMD) is a critical factor in cardiovascular health, extending beyond obstructive atherosclerosis.
  • Recognizing and targeting CMD offers new therapeutic avenues for patients with cardiovascular and myocardial diseases.
  • Further research into CMD mechanisms and management is essential for improving patient outcomes.

Keywords:
Acute coronary syndromesCoronary microvascular dysfunctionCoronary microvascular obstructionMyocardial diseasesStable angina

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