Coronary microvascular dysfunction beyond the spectrum of chronic coronary syndromes

• Published in: Progress in cardiovascular diseases 2024-11, Vol.87, p.73-82
• Main Authors: Belmonte, Marta, Foà, Alberto, Paolisso, Pasquale, Bergamaschi, Luca, Gallinoro, Emanuele, Polimeni, Alberto, Scarsini, Roberto, Muscoli, Saverio, Amicone, Sara, De Vita, Antonio, Villano, Angelo, Angeli, Francesco, Armillotta, Matteo, Sucato, Vincenzo, Tremamunno, Saverio, Morrone, Doralisa, Indolfi, Ciro, Filardi, Pasquale Perrone, Ribichini, Flavio, Lanza, Gaetano Antonio, Chieffo, Alaide, Barbato, Emanuele, Pizzi, Carmine
• Format: Article
• Language: English
• Subjects: Aortic stenosis (AS); Cardiomyopathies; Chronic coronary syndromes (CCS); Coronary microvascular dysfunction (CMD); Heart failure (HF); Takotsubo syndrome (TTS)
• ISSN: 0033-0620
• DOI: 10.1016/j.pcad.2024.10.006

The prevalence of coronary microvascular dysfunction (CMD) beyond the spectrum of chronic coronary syndromes (CCS) is non-negligible, pertaining to pathophysiological and therapeutical implications. Thanks to the availability of accurate and safe non-invasive technique, CMD can be identified as a key player in heart failure, cardiomyopathies, Takotsubo syndrome, aortic stenosis. While CMD is widely recognized as a cause of myocardial ischemia leading to a worse prognosis even in the absence of obstructive coronary artery disease, the characterization of CMD patterns beyond CCS might provide valuable insights on the underlying disease progression, being potentially a “red flag” of adverse cardiac remodeling and a major determinant of response to therapy and outcomes. In this review, we aimed to provide an overview of the latest evidence on the prevalence, mechanistic and prognostic implications of CMD beyond the spectrum of CCS (i.e. heart failure, cardiomyopathies, Takotsubo syndrome, aortic stenosis). [Display omitted]