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Mechanisms of Coronary Microvascular Dysfunction

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Coronary Microvascular Dysfunction

Abstract

CMD can be sustained by several pathogenetic mechanisms. The importance of these mechanisms appears to vary in different clinical settings, but several of them may coexist in the same condition. Structural abnormalities of small coronary arteries can be responsible for CMD and have been described, in particular, in patients with hypertrophic cardiomyopathy or arterial hypertension. Functional microvascular abnormalities responsible for CMD have been described in most cases, and may consist of impaired coronary microvascular dilatation (endothelium-dependent and/or endothelium-independent) and/or increased coronary microvascular constriction. Finally, extravascular mechanisms, resulting in increased compression of resistive vessels by increased intramural pressure, may also sustain CMD.

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Authors and Affiliations

  1. Division of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Filippo Crea & Gaetano A. Lanza

  2. Division of Cardiovascular Medicine, “Vita e Salute” University and Istituto Scientifico San Raffaele, Via Olgettina, 60, 20132, Milan, Italy

    Paolo G. Camici

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  1. Filippo Crea
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  2. Gaetano A. Lanza
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Correspondence to Filippo Crea .

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Crea, F., Lanza, G.A., Camici, P.G. (2014). Mechanisms of Coronary Microvascular Dysfunction. In: Coronary Microvascular Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-5367-0_2

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