Microvascular Dysfunction across the Spectrum of Heart Failure Pathology: Pathophysiology, Clinical Features and...

Area of Science:

• Cardiology
• Pathophysiology
• Translational Medicine

Background:

• Coronary microvascular dysfunction (CMD) significantly impacts heart failure (HF) development, progression, and patient outcomes.
• The intricate pathophysiological links between CMD and HF, including inflammation, oxidative stress, and neurohormonal activation, require further elucidation.
• Current therapeutic strategies do not specifically target CMD in HF patients, despite its diagnostic and prognostic importance.

Purpose of the Study:

• To review the clinical and pathogenetic mechanisms connecting CMD to the spectrum of HF.
• To discuss the prognostic implications of CMD in HF.
• To explore potential therapeutic targets and identify knowledge gaps in managing CMD in HF.

Main Methods:

• Comprehensive literature review of studies investigating CMD and HF.
• Analysis of pathophysiological pathways linking microvascular dysfunction to cardiac dysfunction.
• Synthesis of current evidence on diagnostic challenges and therapeutic approaches.

Main Results:

• CMD is implicated in various HF etiologies and contributes to adverse outcomes.
• Mechanisms involve inflammation, oxidative stress, and neurohormonal imbalances.
• Diagnostic tools for CMD in HF are limited, and specific treatments are lacking.

Conclusions:

• CMD is a critical but complex component of HF pathophysiology.
• Further research is needed to refine diagnostic methods and develop targeted therapies for CMD to improve HF management.
• Addressing CMD holds promise for advancing HF treatment strategies.