Frontiers in Cardiovascular Medicine (Jan 2023)

Coronary microvascular dysfunction: A review of recent progress and clinical implications

  • Rajan Rehan,
  • Rajan Rehan,
  • Rajan Rehan,
  • Andy Yong,
  • Andy Yong,
  • Martin Ng,
  • Martin Ng,
  • James Weaver,
  • Rajesh Puranik,
  • Rajesh Puranik

DOI
https://doi.org/10.3389/fcvm.2023.1111721
Journal volume & issue
Vol. 10

Abstract

Read online

The coronary microcirculation plays a cardinal role in regulating coronary blood flow to meet the changing metabolic demands of the myocardium. Coronary microvascular dysfunction (CMD) refers to structural and functional remodeling of the coronary microcirculation. CMD plays a role in the pathogenesis of obstructive and non-obstructive coronary syndromes as well as myocardial diseases, including heart failure with preserved ejection fraction (HFpEF). Despite recent diagnostic advancements, CMD is often under-appreciated in clinical practice, and may allow for the development of novel therapeutic targets. This review explores the diagnosis and pathogenic role of CMD across a range of cardiovascular diseases, its prognostic significance, and the current therapeutic landscape.

Keywords