Microvascular arterial disease of the brain and the heart: a shared pathogenesis

Area of Science:

• Cardiovascular Science
• Neurology
• Vascular Biology

Background:

• Microvascular arterial disease in the heart is known as coronary microvascular dysfunction (CMD), leading to microvascular angina, increased morbidity, and mortality.
• Microvascular arterial disease in the brain is termed cerebrovascular small vessel disease (SVD), contributing to 45% of dementias and 25% of ischemic strokes.

Purpose of the Study:

• To explore the shared vascular anatomy and pathogenic risk factors between CMD and cerebrovascular SVD.
• To investigate common multisystem pathophysiological mechanisms underlying microvascular disease in the heart and brain.

Main Methods:

• Comparative analysis of vascular anatomy in the heart and brain.
• Review of common risk factors and pathophysiological pathways implicated in CMD and cerebrovascular SVD.
• Literature synthesis on current diagnostic approaches and epidemiological data.

Main Results:

• The heart and brain exhibit similar vascular structures susceptible to microvascular disease.
• Shared risk factors, including hypertension and diabetes, contribute to both CMD and cerebrovascular SVD.
• Evidence suggests common underlying pathophysiological mechanisms across multisystem vascular beds.

Conclusions:

• CMD and cerebrovascular SVD are interconnected conditions with shared etiology and pathophysiology.
• Further investigation into diagnostic tools, epidemiology, and disease-modifying therapies for these microvascular diseases is warranted.