A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings.
Obstructive disease of the large coronary arteries is the prominent cause for angina pectoris. However, angina may also occur in the absence of significant coronary atherosclerosis or coronary artery spasm, especially in women. Myocardial ischaemia in these patients is often associated with abnormalities of the coronary microcirculation and may thus represent a manifestation of coronary microvascular disease (CMD). Elucidation of the role of the microvasculature in the genesis of myocardial ischaemia and cardiac damage-in the presence or absence of obstructive coronary atherosclerosis-will certainly result in more rational diagnostic and therapeutic interventions for patients with ischaemic heart disease. Specifically targeted research based on improved assessment modalities is needed to improve the diagnosis of CMD and to translate current molecular, cellular, and physiological knowledge into new therapeutic options.
Department of Physiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Arnimallee 22, D-14195 Berlin, Germany.
Axel R
AR
Pries
Helmut
H
Habazettl
Giuseppe
G
Ambrosio
Peter Riis
PR
Hansen
Juan Carlos
JC
Kaski
Volker
V
Schächinger
Harald
H
Tillmanns
Giuseppe
G
Vassalli
Isabella
I
Tritto
Michael
M
Weis
Cor
C
de Wit
Raffaele
R
Bugiardini
D000787:Angina Pectoris / Q000209:etiology* / Q000503:physiopathology; D000818:Animals; D003326:Coronary Circulation; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003935:Diagnostic Techniques, Cardiovascular; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D008833:Microcirculation; D017202:Myocardial Ischemia / Q000209:etiology* / Q000503:physiopathology