Pathophysiology, classification, and MRI parallels in microvascular disease of the heart and brain

Area of Science:

• Cardiovascular Imaging
• Neurology
• Vascular Medicine

Background:

• Diagnostic imaging traditionally focused on large vessel disease.
• Emerging techniques now allow investigation of microvascular disease mechanisms and prognosis.
• Microvascular disease in the heart and brain significantly impacts patient health, leading to conditions like heart attack, stroke, and dementia.

Purpose of the Study:

• To discuss parallels in pathophysiology, classification, and diagnostic modalities for cardiac and cerebral microvascular disease.
• To emphasize the role of magnetic resonance imaging (MRI) in diagnosing these conditions.
• To present novel imaging approaches and identify research gaps.

Main Methods:

• Review of current literature on microvascular disease in the heart and brain.
• Focus on magnetic resonance imaging (MRI) techniques.
• Discussion of novel intravascular contrast agents, such as ferumoxytol.

Main Results:

• Parallels exist in the pathophysiology and classification of coronary microvascular disease and cerebral small vessel disease.
• MRI is a key diagnostic modality for both cardiac and cerebral microvascular disease.
• Novel contrast agents show promise for streamlined imaging.

Conclusions:

• Microvascular disease in the heart and brain shares common features and diagnostic challenges.
• Advanced imaging, including MRI and new contrast agents, is crucial for diagnosis and understanding.
• Further research is needed to address diagnostic gaps in microvascular disease.