Pathogenesis, Assessment, and Treatment of Coronary Microcirculation Dysfunction

Area of Science:

• Cardiology
• Vascular Biology
• Women's Health

Background:

• Cardiovascular disease is a leading global cause of death.
• Women with myocardial ischemia symptoms are more likely to have non-obstructive coronary artery disease (CAD) than men.
• Women often experience a higher symptom burden and may be misdiagnosed due to the absence of obstructive CAD.

Purpose of the Study:

• To review the prevalence, mechanisms, diagnostics, and treatments for coronary microvascular dysfunction (CMD).
• To highlight CMD as a critical consideration in patients with ischemic heart disease symptoms but without obstructive CAD.
• To underscore the link between CMD and adverse cardiovascular outcomes.

Main Methods:

• Literature review of studies on coronary microvascular dysfunction.
• Analysis of diagnostic criteria and imaging modalities for CMD.
• Examination of current and potential therapeutic strategies for CMD.

Main Results:

• Coronary microvascular dysfunction, marked by impaired coronary flow reserve, is associated with poor cardiovascular outcomes.
• Functional or structural microcirculatory abnormalities underlie CMD.
• Further clinical trials are needed to establish optimal treatment strategies.

Conclusions:

• Coronary microvascular dysfunction is a significant factor in ischemic heart disease, particularly in women.
• Early consideration and diagnosis of CMD are crucial for appropriate patient management.
• Lifestyle modifications and specific medications show potential but require further validation.