Sex differences in diagnostic modalities of coronary artery disease: Evidence from coronary microcirculation

Area of Science:

• Cardiology
• Vascular Biology
• Medical Diagnostics

Background:

• Atherosclerosis, typically a large artery disease, also impacts microvascular structures.
• Microvascular dysfunction is a key factor in cardiac disease, particularly in women.
• Women exhibit a distinct clinical phenotype of ischemic disease due to impaired coronary microcirculation.

Purpose of the Study:

• To review diagnostic modalities for assessing coronary microvascular function.
• To highlight the sex-specific differences in microvascular disease presentation and diagnosis.
• To emphasize the importance of selecting appropriate diagnostic tools based on patient sex.

Main Methods:

• Summary of invasive diagnostic techniques, including catheter-based endothelial function assessment.
• Overview of non-invasive methods such as Doppler echocardiography and positron emission tomography.
• Discussion of clinical settings where microvascular disease is prevalent.

Main Results:

• Microvascular dysfunction is a significant component of atherosclerosis, with notable sex differences.
• Coronary microvascular dysfunction is more prevalent in women, necessitating tailored diagnostic approaches.
• Various invasive and non-invasive tools are available for evaluating coronary microvascular function.

Conclusions:

• Diagnostic strategies for coronary microvascular dysfunction must account for sex-based variations.
• Choosing the correct diagnostic modality is crucial for effective management of microvascular disease.
• Understanding sex-specific phenotypes improves the diagnosis and treatment of cardiac microvascular issues.