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

Author:

Konst Regina E1ORCID,Guzik Tomasz J2,Kaski Juan-Carlos34ORCID,Maas Angela H E M1,Elias-Smale Suzette E1ORCID

Affiliation:

1. Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands

2. Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, UK

3. The Queen Elizabeth Hospital Discipline of Medicine, University of Adelaide, Central Adelaide Local Health Network, Coronary Vasomotion Disorders International Study Group (COVADIS), Adelaide, Australia

4. Molecular and Clinical Sciences Research Institute, St George’s, University of London, London, UK

Abstract

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.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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