Abstract
Over the past two decades, coronary microvascular dysfunction (CMD) has emerged as an important mechanism of myocardial ischemia. This chapter describes various pathogenic mechanisms of CMD and explains how CMD can result from functional and/or structural alterations to the vessel wall and lead to varying degrees of disruption to normal coronary physiology. Currently ≈20–50% of patients have a predisposition towards ongoing angina despite successful revascularization surgery. The current goal of percutaneous coronary intervention (PCI) or any other revascularization therapy is to relieve the symptoms rather than address the pathology. It will require new research in this area if an improvement in CMD pathology is to be achieved.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011 Dec;32(23):2999–3054.
Camici PG, Rimoldi OE, Crea F. Chapter 5 – Coronary microvascular dysfunction. In: de Lemos JA, Omland T, editors. Chronic coronary artery disease. Philadelphia: Elsevier; 2018. p. 55–68.
Ford TJ, Corcoran D, Berry C. Stable coronary syndromes: pathophysiology, diagnostic advances and therapeutic need. Heart. 2018;104(4):284.
Camici PG, d’Amati G, Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol. 2015;12(1):48–62.
Naderi S. Microvascular coronary dysfunction—an overview. Curr Atheroscler Rep. 2018;20(2):7.
Crea F, Lanza GA, Camici PG. CMD in the absence of myocardial diseases and obstructive CAD. In: Crea F, Lanza GA, Camici PG, editors. Coronary microvascular dysfunction. Milano: Springer; 2014. p. 75–114.
Crea F, Lanza GA, Camici PG. Mechanisms of coronary microvascular dysfunction. In: Crea F, Lanza GA, Camici PG, editors. Coronary microvascular dysfunction. Milano: Springer; 2014. p. 31–47.
Böse D, von Birgelen C, Zhou XY, Schmermund A, Philipp S, Sack S, et al. Impact of atherosclerotic plaque composition on coronary microembolization during percutaneous coronary interventions. Basic Res Cardiol. 2008;103(6):587–97.
Juan-Carlos K, Filippo C, Gersh BJ, Camici PG. Reappraisal of ischemic heart disease. Circulation. 2018;138(14):1463–80.
Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(15):1503–16.
Izzo P, Macchi A, De Gennaro L, Gaglione A, Di Biase M, Brunetti ND. Recurrent angina after coronary angioplasty: mechanisms, diagnostic and therapeutic options. Eur Heart J Acute Cardiovasc Care. 2012;1(2):158–69.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2020 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
King, M.W., Bambharoliya, T., Ramakrishna, H., Zhang, F. (2020). Coronary Microvascular Dysfunction (CMD). In: Coronary Artery Disease and The Evolution of Angioplasty Devices. SpringerBriefs in Materials. Springer, Cham. https://doi.org/10.1007/978-3-030-42443-5_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-42443-5_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-42442-8
Online ISBN: 978-3-030-42443-5
eBook Packages: Chemistry and Materials ScienceChemistry and Material Science (R0)