Coronary Microvascular Dysfunction Across the Spectrum of Cardiovascular Diseases: JACC State-of-the-Art Review.
Coronary Microvascular Dysfunction Across the Spectrum of Cardiovascular Diseases: JACC State-of-the-Art Review.
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DOI：
10.1016/j.jacc.2021.07.042
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发表时间：
2021-09-28
影响因子：
24
通讯作者：
Crea F
中科院分区：
文献类型：
--
作者：
Del Buono MG;Montone RA;Camilli M;Carbone S;Narula J;Lavie CJ;Niccoli G;Crea F
冠状动脉微血管功能障碍（CMD）包括几种涉及冠状动脉微循环的发病机制，在无阻塞性冠状动脉疾病（CAD）心绞痛患者以及其他几种疾病（包括阻塞性CAD、非缺血性心肌病、Takotsubo综合征和心力衰竭）的心肌缺血中起主要作用，特别是与保留射血分数相关的表型。不幸的是，尽管在几种情况下确定了CMD的病理生理和预后作用，但迄今为止，还没有针对CMD的特异性治疗方法。由于CMD在不同的临床表型中扮演着共同的角色，因此有必要在这一领域进行进一步的研究，以便为这种“普通品种”的患者提供个性化的治疗。本文的目的是描述CMD的病理生理机制及其在不同心血管疾病中的作用。我们还将讨论最近临床研究的诊断方式和潜在的治疗策略。冠状动脉微血管功能障碍（CMD）在多种心血管疾病中普遍存在。在不同的临床实体中，CMD作为公分母的新兴作用要求解决这些具有CMD证据的异质性患者的管理知识差距。我们修订了CMD的病理生理机制，其在不同心血管疾病中的预后作用，临床实践中常用的诊断方式以及最佳患者管理的潜在治疗策略。
Coronary microvascular dysfunction (CMD) encompasses several pathogenetic mechanisms involving coronary microcirculation and plays a major role in determining myocardial ischemia in patients with angina without obstructive coronary artery disease (CAD), as well as in several other conditions, including obstructive CAD, non-ischemic cardiomyopathies, Takotsubo syndrome and heart failure, especially the phenotype associated with preserved ejection fraction. Unfortunately, despite the identified pathophysiological and prognostic role of CMD in several conditions, to date, there is no specific treatment for CMD. Due to the emerging role of CMD as common denominator in different clinical phenotypes, additional research in this area is warranted in order to provide personalized treatments in this “garden variety” of patients. The purpose of this review is to describe the pathophysiological mechanisms of CMD and its mechanistic and prognostic role across different cardiovascular diseases. We will also discuss diagnostic modalities and the potential therapeutic strategies resulting from recent clinical studies. Coronary microvascular dysfunction (CMD) is prevalent across several cardiovascular conditions. The emerging role of CMD as common denominator in different clinical entities, calls for addressing knowledge gaps for the management of these heterogeneous patients with evidence of CMD. We revise the pathophysiological mechanisms of CMD, its prognostic role across different cardiovascular diseases, the diagnostic modalities commonly used in clinical practice and the potential therapeutic strategies for optimal patient management.
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影响因子：
2.8
作者：
Chen, JW;Hsu, NW;Chang, MS
通讯作者：
Chang, MS
影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
18.2
作者：
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通讯作者：
Lerman, Amir
DOI：
10.1016/j.jchf.2014.03.009
发表时间：
2014-08
期刊：
JACC. Heart failure
影响因子：
--
作者：
Dorbala S;Vangala D;Bruyere J Jr;Quarta C;Kruger J;Padera R;Foster C;Hanley M;Di Carli MF;Falk R
通讯作者：
Falk R