ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on 'coronary microvascular dysfunction in cardiovascular disease'
Por:
Padro, T, Manfrini, O, Bugiardini, R, Canty, J, Cenko, E, De Luca, G, Duncker, DJ, Eringa, EC, Koller, A, Tousoulis, D, Trifunovic, D, Vavlukis, M, de Wit, C, Badimon, L
Publicada:
15 mar 2020
Resumen:
Although myocardial ischaemia usually manifests as a consequence of atherosclerosis-dependent obstructive epicardial coronary artery disease, a significant percentage of patients suffer ischaemic events in the absence of epicardial coronary artery obstruction. Experimental and clinical evidence highlight the abnormalities of the coronary microcirculation as a main cause of myocardial ischaemia in patients with `normal or near normal' coronary arteries on angiography. Coronary microvascular disturbances have been associated with early stages of atherosclerosis even prior to any angiographic evidence of epicardial coronary stenosis, as well as to other cardiac pathologies such as myocardial hypertrophy and heart failure. The main objectives of the manuscript are (i) to provide updated evidence in our current understanding of the pathophysiological consequences of microvascular dysfunction in the heart; (ii) to report on the current knowledge on the relevance of cardiovascular risk factors and comorbid conditions for microcirculatory dysfunction; and (iii) to evidence the relevance of the clinical consequences of microvascular dysfunction. Highlighting the clinical importance of coronary microvascular dysfunction will open the field for research and the development of novel strategies for intervention will encourage early detection of subclinical disease and will help in the stratification of cardiovascular risk in agreement with the new concept of precision medicine.
Filiaciones:
Padro, T:
Hosp Santa Creu & Sant Pau, Cardiovasc Program ICCC, Res Inst, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Autonomous Univ Barcelona UAB, Cardiovasc Res Chair, Barcelona, Spain
Manfrini, O:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
Bugiardini, R:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
Canty, J:
SUNY Buffalo, Dept Med, Div Cardiol, Buffalo, NY USA
Cenko, E:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
De Luca, G:
Eastern Piedmont Univ, Maggiore Carita Hosp, Div Cardiol, Novara, Italy
Duncker, DJ:
Erasmus MC, Thoraxctr, Cardiovasc Res Inst COEUR, Div Expt Cardiol,Dept Cardiol, Rotterdam, Netherlands
Eringa, EC:
Univ Amsterdam, Amsterdam Cardiovasc Sci Inst, Dept Physiol, Med Ctr, Amsterdam, Netherlands
Koller, A:
Semmelweis Univ, Fac Med, Dept Translat Med, Budapest, Hungary
New York Med Coll, Dept Physiol, Valhalla, NY 10595 USA
Tousoulis, D:
Univ Athens, Hippokrat Hosp, Dept Cardiol 1, Med Sch, Athens, Greece
Trifunovic, D:
Univ Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia
Univ Belgrade, Sch Med, Belgrade, Serbia
Vavlukis, M:
Ss Cyril & Methodius Univ, Univ Clin Cardiol, Med Fac, Skopje, North Macedonia
de Wit, C:
Univ Lubeck, Inst Physiol, Lubeck, Germany
DZHK German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Lubeck, Lubeck, Germany
Badimon, L:
Hosp Santa Creu & Sant Pau, Cardiovasc Program ICCC, Res Inst, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Autonomous Univ Barcelona UAB, Cardiovasc Res Chair, Barcelona, Spain
Green Published
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