The pathogenic role of coronary microvascular dysfunction in the setting of other cardiac or systemic conditions

Cardiovasc Res. 2020 Mar 1;116(4):817-828. doi: 10.1093/cvr/cvaa009.

Abstract

Coronary microvascular dysfunction (CMD) plays a pathogenic role in cardiac and systemic conditions other than microvascular angina. In this review, we provide an overview of the pathogenic role of CMD in the setting of diabetes mellitus, obesity, hypertensive pregnancy disorders, chronic inflammatory and autoimmune rheumatic disorders, chronic kidney disease, hypertrophic cardiomyopathy, and aortic valve stenosis. In these various conditions, CMD results from different structural, functional, and/or dynamic alterations in the coronary microcirculation associated with the primary disease process. CMD is often detectable very early in the course of the primary disease, before clinical symptoms or signs of myocardial ischaemia are present, and it portrays an increased risk for cardiovascular events.

Keywords: Comorbidities; Coronary microvascular dysfunction; Endothelial dysfunction; Inflammation; Microvascular angina.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology*
  • Comorbidity
  • Coronary Circulation*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Microcirculation*
  • Microvessels / diagnostic imaging
  • Microvessels / physiopathology*
  • Pregnancy
  • Prognosis
  • Risk Factors