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Coronary microvascular dysfunction in chronic inflammatory rheumatoid diseases

Alessia Faccini1, Juan Carlos Kaski2, Paolo G Camici3

  • 1Vita-Salute University and San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan, Italy.

European Heart Journal
|February 26, 2016
PubMed

Insights

Chronic inflammatory rheumatoid diseases (CIRD) increase cardiovascular risk. Understanding coronary microvascular dysfunction (CMD) in CIRD is key to developing targeted therapies and preventing heart disease.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Chronic inflammatory rheumatoid diseases (CIRD) like rheumatoid arthritis, lupus, and scleroderma are significant risk factors for ischemic heart disease.
  • CIRD contributes to high cardiovascular morbidity and mortality.
  • Inflammation in CIRD can impair coronary microvascular function, leading to myocardial ischemia and cardiovascular events, even without obstructive coronary artery disease.

Purpose of the Study:

  • To review the pathogenic mechanisms underlying coronary microvascular dysfunction (CMD) in CIRD.
  • To discuss controversial therapeutic strategies for CMD in CIRD.
  • To propose a diagnostic algorithm for CMD in CIRD patients to guide preventive measures.

Main Methods:

  • Literature review of pathogenic mechanisms.
  • Analysis of therapeutic strategies and their outcomes.
  • Development of a proposed diagnostic algorithm.

Main Results:

  • Inflammation in CIRD directly impacts coronary microvascular function.
  • Current therapeutic strategies show controversial results.
  • A diagnostic algorithm can aid in identifying CMD.

Conclusions:

  • Understanding CMD mechanisms in CIRD is crucial for identifying therapeutic targets.
  • Early identification of CMD through a diagnostic algorithm may prevent angina and slow disease progression.
  • Targeting CMD could reduce cardiovascular events in CIRD patients.

Keywords:
Coronary microvascular dysfunctionInflammationMicrovascular anginaRheumatic diseasesRheumatoid arthritisSystemic lupus erythematosusSystemic sclerosis

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