[Microvascular dysfunction and myocardial ischemia].
Functional or structural lesions in intramural arterioles influence the ischemic threshold of the myocardium. Microvascular dysfonction is evidenced by a decrease in coronary blood flow during maximum hyperemia in the presence of angiographically normal or near-normal coronary arteries. Microvascular dysfonction may reflect endothelial dysfonction in diabetic or hyperlipidemic patients, as well as structural and functional changes in patients with hypertrophic cardiomyopathy, aortic stenosis or hypertension. Assessing microvascular fonction after thrombolysis or primary angioplasty for acute myocardial infarction allows to estimate the quality of myocardial reperfusion. Assessing microvascular fonction is a major component of the evaluation of myocardial ischemia in the absence of coronary artery stenoses.
Vassalli
Giuseppe
G
Division de cardiologie, Service de cardiologie et Pôle cardiovasculaire et métabolique, CHUV, Lausanne. giuseppe.vassalli@chuv.ch
Eeckhout
Eric
E
Vogt
Pierre
P
Kappenberger
Lukas
L
D006801:Humans; D017202:Myocardial Ischemia / Q000209:etiology*; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis