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Exploring coronary microvascular dysfunction from functional impairment and structural damage
Wei Wen1, Yiqing Zhang2, Genlin Jia3
1Department of Cardiovascular Diseases, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China.
Frontiers in Cardiovascular Medicine
|February 16, 2026
Summary
Coronary microvascular dysfunction (CMD) impairs heart function, leading to heart failure. Understanding its structural and functional aspects is key for new diagnostic and treatment strategies.
Area of Science:
- Cardiovascular Research
- Pathophysiology
- Medical Science
Background:
- Coronary microvascular dysfunction (CMD) involves impaired heart blood flow due to issues in small vessels.
- CMD is increasingly linked to heart failure with preserved ejection fraction (HFpEF).
- Endothelial dysfunction, affecting cell structure and function, is central to CMD pathogenesis.
Purpose of the Study:
- To systematically review the pathophysiological features of CMD.
- To focus on microcirculatory functional regulation and vascular structural remodeling in CMD.
- To provide a foundation for improved clinical diagnosis and treatment of CMD.
Main Methods:
- Systematic review of pathophysiological features of CMD.
- Analysis of microcirculatory functional regulation.
- Examination of vascular structural remodeling.
Main Results:
- CMD involves both functional and structural impairments of the coronary microvasculature.
- Heterogeneity in CMD clinical phenotypes is linked to functional and structural injuries.
- Endothelial dysfunction plays a critical role in CMD development.
Conclusions:
- CMD is a complex syndrome requiring multidimensional investigation.
- Understanding CMD's dual nature (functional and structural) is crucial.
- This review offers insights for advancing CMD diagnosis and therapy.
Keywords:
coronary flow reservecoronary microvascular dysfunctionfunctional impairmentindex of microcirculatory resistanceischemic heart diseasestructural damageMore Related Videos
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