Coronary microvascular dysfunction in stable ischaemic heart disease (non-obstructive coronary artery disease and obstructive coronary artery disease)

Udo Sechtem, David Brown, Shigeo Godo, Gaetano Antonio Lanza, Hiro Shimokawa, Novalia Sidik

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)

Abstract

Diffuse and focal epicardial coronary disease and coronary microvascular abnormalities may exist side-by-side. Identifying the contributions of each of these three players in the coronary circulation is a difficult task. Yet identifying coronary microvascular dysfunction (CMD) as an additional player in patients with coronary artery disease (CAD) may provide explanations of why symptoms may persist frequently following and why global coronary flow reserve may be more prognostically important than fractional flow reserve measured in a single vessel before percutaneous coronary intervention. This review focuses on the challenges of identifying the presence of CMD in the context of diffuse non-obstructive CAD and obstructive CAD. Furthermore, it is going to discuss the pathophysiology in this complex situation, examine the clinical context in which the interaction of the three components of disease takes place and finally look at non-invasive diagnostic methods relevant for addressing this question.

Original languageEnglish
Pages (from-to)771-786
Number of pages16
JournalCardiovascular Research
Volume116
Issue number4
DOIs
Publication statusPublished - 2020 Mar 1

Keywords

  • Coronary microvascular dysfunction
  • Fractional flow reserve
  • Index of microvascular resistance
  • Non-obstructive coronary artery disease
  • Obstructive coronary artery disease
  • Pathophysiology

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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