Coronary Microvascular Dysfunction: an Update

Overview

Journal Eur Heart J

Publisher Oxford University Press

Specialty Cardiology & Vascular Diseases

Date 2013 Dec 25

PMID 24366916

Citations 297

Authors

Filippo Crea

Paolo G Camici

Cathleen Noel Bairey Merz

Affiliations

Soon will be listed here.

Abstract

Many patients undergoing coronary angiography because of chest pain syndromes, believed to be indicative of obstructive atherosclerosis of the epicardial coronary arteries, are found to have normal angiograms. In the past two decades, a number of studies have reported that abnormalities in the function and structure of the coronary microcirculation may occur in patients without obstructive atherosclerosis, but with risk factors or with myocardial diseases as well as in patients with obstructive atherosclerosis; furthermore, coronary microvascular dysfunction (CMD) can be iatrogenic. In some instances, CMD represents an epiphenomenon, whereas in others it is an important marker of risk or may even contribute to the pathogenesis of cardiovascular and myocardial diseases, thus becoming a therapeutic target. This review article provides an update on the clinical relevance of CMD in different clinical settings and also the implications for therapy.

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