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Coronary microvascular dysfunction: sex-specific risk, diagnosis, and therapy
Jenna Dean1, Sherwin Dela Cruz1, Puja K Mehta1
1Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, A3600, Los Angeles, CA 90048, USA.
Nature Reviews. Cardiology
|May 27, 2015
Summary
Coronary microvascular dysfunction is a key cause of myocardial ischaemia, especially in women who often lack obstructive coronary artery disease. Further research is needed to guide effective treatments for this condition.
Area of Science:
- Cardiology
- Vascular Medicine
- Women's Health
Background:
- Cardiovascular disease remains the leading global cause of mortality.
- Women with myocardial ischaemia symptoms frequently lack obstructive coronary artery disease (CAD), leading to misdiagnosis.
- Coronary microvascular dysfunction (CMD) is increasingly recognized as a cause of ischaemic heart disease.
Purpose of the Study:
- To review the prevalence, presentation, diagnosis, and treatment of coronary microvascular dysfunction.
- To highlight the specific challenges and considerations for ischaemic heart disease in women.
- To emphasize the importance of considering CMD in patients without obstructive CAD.
Main Methods:
- This is a review article, synthesizing existing literature.
- The review discusses diagnostic criteria and therapeutic approaches for CMD.
- Emphasis is placed on clinical presentation and epidemiological data.
Main Results:
- Coronary microvascular dysfunction is characterized by impaired coronary flow reserve due to microcirculatory abnormalities.
- It is associated with adverse cardiovascular outcomes and is often overlooked in women.
- Current treatments may include lifestyle changes and medications, but outcome data are limited.
Conclusions:
- Coronary microvascular dysfunction is a significant contributor to ischaemic heart disease, particularly in women.
- Accurate diagnosis and targeted therapies for CMD are crucial for improving cardiovascular prognosis.
- Further clinical trials are essential to establish evidence-based treatment guidelines for CMD.
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