Microvascular Dysfunction as a Systemic Disease: A Review of the Evidence.

Area of Science:

• Cardiovascular Science
• Nephrology
• Neurology
• Ophthalmology
• Pulmonology

Background:

• Microvascular dysfunction encompasses vessel destruction, abnormal vasoreactivity, thrombosis, and fibrosis, leading to organ damage and failure.
• Clinical manifestations include ischemic heart disease, renal failure, stroke, blindness, pulmonary arterial hypertension, and dementia.
• A unifying hypothesis posits microvascular dysfunction as a systemic illness exacerbated by aging and vascular risk factors.

Purpose of the Study:

• To review evidence supporting microvascular dysfunction as a global pathologic process.
• To explore shared mechanisms across diverse microvascular diseases affecting multiple organs.
• To focus on studies examining concomitant cardiac microvascular dysfunction with that of the brain, kidney, retina, and lung.

Main Methods:

• Systematic review of existing literature.
• Analysis of studies reporting concurrent microvascular dysfunction in multiple organ systems.
• Synthesis of evidence linking systemic factors to organ-specific microvascular pathology.

Main Results:

• Evidence supports the concept of microvascular dysfunction as a systemic condition rather than isolated organ pathology.
• Shared pathological pathways are implicated across microvascular diseases affecting the heart, brain, kidneys, retina, and lungs.
• Concomitant microvascular dysfunction in the heart and other organs is frequently reported.

Conclusions:

• Microvascular dysfunction represents a unifying, systemic pathologic process.
• Understanding shared mechanisms can guide the development of novel therapeutic strategies for a range of diseases.
• Further research into systemic factors is crucial for effective treatment of organ-specific microvascular damage.