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Left ventricular diastolic dysfunction in women with nonobstructive ischemic heart disease: insights from magnetic
1Applied Physiology and Advanced Imaging Laboratory, University of Texas at Arlington, Arlington, Texas michael.nelson3@uta.edu.
Insights
Nonobstructive ischemic heart disease (NOIHD) is common in women and increases the risk of heart attack and stroke. This review covers NOIHD, its link to heart failure with preserved ejection fraction (HFpEF), and treatment options.
Area of Science:
- Cardiology
- Cardiovascular Disease Research
Background:
- Ischemic heart disease without obstructive coronary artery disease (NOIHD) is increasingly recognized as a significant cardiovascular risk, particularly in women.
- Historically underestimated, NOIHD is now understood to contribute to major adverse cardiovascular events like myocardial infarction, stroke, and heart failure.
- NOIHD poses a substantial burden on healthcare systems, necessitating a deeper understanding of its pathophysiology and management.
Purpose of the Study:
- To review the current understanding of nonobstructive ischemic heart disease (NOIHD).
- To explore the association between NOIHD and left ventricular diastolic dysfunction.
- To examine potential links between NOIHD and heart failure with preserved ejection fraction (HFpEF), and discuss therapeutic strategies and knowledge gaps.
Main Methods:
- This is a review article.
- Literature search on NOIHD, diastolic dysfunction, HFpEF, and cardiovascular events.
- Synthesis of current evidence and identification of research gaps.
Main Results:
- NOIHD is a prevalent condition associated with significant cardiovascular risk.
- A strong link exists between NOIHD and left ventricular diastolic dysfunction.
- NOIHD is implicated in the development of HFpEF, highlighting the need for targeted therapies.
Conclusions:
- NOIHD is a critical clinical entity requiring greater attention and research.
- Understanding the mechanisms linking NOIHD to diastolic dysfunction and HFpEF is crucial for effective patient management.
- Further research is needed to establish optimal therapeutic approaches for patients with NOIHD.
Abstract:
Ischemic heart disease, in the absence of obstructive coronary artery disease, is prevalent in women and constitutes a major risk factor for developing major adverse cardiovascular events, including myocardial infarction, stroke, and heart failure. For decades, diagnosis was considered benign and often minimized; however, it is now known that this etiology carries much risk and is a significant burden to the health care system. This review summarizes the current state of knowledge on nonobstructive ischemic heart disease (NOIHD), the association between NOIHD and left ventricular diastolic dysfunction, potential links between NOIHD and the development of heart failure with preserved ejection fraction (HFpEF), and therapeutic options and knowledge gaps for patients living with NOIHD.
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