Role of Inflammation in Coronary Epicardial and Microvascular Dysfunction.
Role of Inflammation in Coronary Epicardial and Microvascular Dysfunction.
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炎症在冠状动脉心外膜和微血管功能障碍中的作用。
DOI：
10.15420/ecr.2020.47
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Shimokawa H
中科院分区：
文献类型：
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作者：
Godo S;Takahashi J;Yasuda S;Shimokawa H
在各种实验和临床环境中，越来越多的证据强调炎症和冠状动脉微血管功能障碍（CMD）之间的密切关系，具有重大的临床意义。慢性低度血管炎症在CMD背后的潜在机制中起重要作用，特别是在患有冠状动脉疾病、肥胖、射血分数保留的心力衰竭和慢性炎症性类风湿性疾病的患者中。冠状动脉血管运动异常的中心机制包括冠状动脉血管收缩反应性增强、内皮依赖性和非内皮依赖性冠状动脉血管扩张能力降低和冠状动脉微血管阻力增加，其中炎症介质和反应实质上参与其中。如何调节CMD以改善患有该疾病的患者的临床结果以及通过靶向炎症反应的CMD管理是否可以使患者受益仍然是需要进一步研究的挑战性问题。这篇综述提供了一个简明的概述，目前的知识参与炎症的病理生理和分子机制的CMD从板凳到床边。
There is accumulating evidence highlighting a close relationship between inflammation and coronary microvascular dysfunction (CMD) in various experimental and clinical settings, with major clinical implications. Chronic low-grade vascular inflammation plays important roles in the underlying mechanisms behind CMD, especially in patients with coronary artery disease, obesity, heart failure with preserved ejection fraction and chronic inflammatory rheumatoid diseases. The central mechanisms of coronary vasomotion abnormalities comprise enhanced coronary vasoconstrictor reactivity, reduced endothelium-dependent and -independent coronary vasodilator capacity and increased coronary microvascular resistance, where inflammatory mediators and responses are substantially involved. How to modulate CMD to improve clinical outcomes of patients with the disorder and whether CMD management by targeting inflammatory responses can benefit patients remain challenging questions in need of further research. This review provides a concise overview of the current knowledge of the involvement of inflammation in the pathophysiology and molecular mechanisms of CMD from bench to bedside.