title: Coronary microvascular dysfunction: an update.
abstract: Many patients undergoing coronary angiography because of chest pain syndromes, believed to be indicative of obstructive atherosclerosis of the epicardial coronary arteries, are found to have normal angiograms. In the past two decades, a number of studies have reported that abnormalities in the function and structure of the coronary microcirculation may occur in patients without obstructive atherosclerosis, but with risk factors or with myocardial diseases as well as in patients with obstructive atherosclerosis; furthermore, coronary microvascular dysfunction (CMD) can be iatrogenic. In some instances, CMD represents an epiphenomenon, whereas in others it is an important marker of risk or may even contribute to the pathogenesis of cardiovascular and myocardial diseases, thus becoming a therapeutic target. This review article provides an update on the clinical relevance of CMD in different clinical settings and also the implications for therapy.
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Catholic University of the Sacred Heart, 00187 L.go Vito 1, Roma, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Camici
authors.forename: Cathleen Noel
authors.initials: CN
authors.lastname: Bairey Merz
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000209:etiology; D009202:Cardiomyopathies / Q000209:etiology; D003324:Coronary Artery Disease / Q000209:etiology; D023921:Coronary Stenosis / Q000209:etiology; D005544:Forecasting; D006801:Humans; D017566:Microvascular Angina / Q000145:classification / Q000150:complications* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D012307:Risk Factors
keywords: Acute coronary syndromes; Coronary microvascular dysfunction; Coronary microvascular obstruction; Myocardial diseases; Stable angina