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Updated: Sep 16, 2025
An Intact Pericardium Ischemic Rodent Model
Published on: September 2, 2021
Coronary Microvascular Dysfunction in Ischaemic Heart Disease: Lessons From Large Animal Models
Oana Sorop1, J van de Wouw1, Daphne Merkus1,2,3
1Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Insights
This review explores how the coronary microvasculature (small heart blood vessels) regulates blood flow. It details microvascular dysfunction in ischemic heart disease and suggests future therapeutic targets.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Heart Disease Research
Background:
- The coronary microvasculature is crucial for matching myocardial oxygen supply to demand.
- Regulation involves short-term microvascular tone changes and long-term structural remodeling.
- Understanding these mechanisms is vital, especially in disease states.
Purpose of the Study:
- To review current knowledge on coronary microvascular regulation.
- To discuss microvascular dysfunction in ischemic heart disease (IHD).
- To highlight findings from animal models and human studies.
Main Methods:
- Literature review of functional and structural adaptations.
- Analysis of mechanisms in healthy and diseased states.
- Focus on obstructive and non-obstructive coronary artery disease.
Main Results:
- Coronary microvascular tone and remodeling are key to blood flow regulation.
- Microvascular dysfunction plays a significant role in IHD.
- Evidence from large animal models and human studies supports these findings.
Conclusions:
- Further research is needed to understand disease-specific mechanisms of microvascular dysfunction.
- Identifying therapeutic targets is essential for improving microvascular function in IHD patients.
Abstract:
The coronary microvasculature is principally responsible for matching coronary blood flow to myocardial demand of oxygen and nutrients. Short-term control of coronary blood flow is achieved via alterations in coronary microvascular tone, whereas long-term control of coronary flow also involves remodelling of the coronary microvasculature, including adjustments in vascular structure, diameter and density. In the past 50 years, considerable research efforts have been directed at understanding the functional and structural coronary microvascular adaptations involved in matching myocardial oxygen supply to demand, and how these mechanisms are affected by various diseases. In this review article, we will discuss our current understanding of the mechanisms underlying the regulation of coronary microvascular tone under healthy physiological conditions and in ischaemic heart disease. We will specifically discuss the role of microvascular dysfunction in obstructive and non-obstructive coronary artery disease, as studied in large animal models and confirmed in human studies. Future research should be directed at further unravelling the disease-specific mechanisms of coronary microvascular dysfunction in order to identify therapeutic targets to improve microvascular function in patients with ischaemic heart disease.
