Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options: JACC State-of-the-Art Review.
Coronary Microvascular Disease Pathogenic Mechanisms and Therapeutic Options: JACC State-of-the-Art Review.
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DOI：
10.1016/j.jacc.2018.09.042
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发表时间：
2018-11-27
影响因子：
24
通讯作者：
Di Carli MF
中科院分区：
文献类型：
--
作者：
Taqueti VR;Di Carli MF
冠状动脉微血管疾病（CMD）是指影响冠状动脉微循环结构和功能的疾病子集，在心血管危险因素广泛的患者中普遍存在，并与不良事件风险增加相关。当代证据支持大多数CMD患者同时存在大血管粥样硬化，这对其预后和治疗具有重要意义。在这篇最新的综述中，我们总结了CMD的病理生理学，提供了诊断测试策略的更新，并根据严重程度和与动脉粥样硬化的共存情况将CMD分为表型。我们研究了强调CMD在特定人群中的重要性的新数据，包括肥胖和胰岛素抵抗，心肌损伤和保留射血分数的心力衰竭，以及非阻塞性和阻塞性冠状动脉疾病。最后，我们讨论了CMD作为超越传统方法的新干预措施的潜在目标的作用，它代表了减少心血管疾病的新前沿。冠状动脉微血管疾病（CMD）是指影响冠状动脉微循环结构和功能的一类疾病，在多种心血管危险因素的患者中普遍存在，并与不良事件的风险增加相关。当代证据支持大多数CMD患者同时伴有大血管动脉粥样硬化。在这篇最新的综述中，作者总结了关于CMD的病理生理学的已知知识，提供了诊断测试策略的更新，根据CMD的严重程度和与动脉粥样硬化的共存情况将其分类为临床表型，并讨论了其作为新干预措施的潜在靶点的作用。
Coronary microvascular disease (CMD) refers to the subset of disorders affecting the structure and function of the coronary microcirculation, is prevalent in patients across a broad spectrum of cardiovascular risk factors, and is associated with increased risk of adverse events. Contemporary evidence supports that most patients with CMD also have macrovessel atherosclerosis, which has important implications for their prognosis and management. In this state-of-the-art review, we summarize the pathophysiology of CMD, provide an update of diagnostic testing strategies, and classify CMD into phenotypes according to severity and coexistence with atherosclerosis. We examine emerging data highlighting the significance of CMD in specific populations, including obesity and insulin resistance, myocardial injury and heart failure with preserved ejection fraction, and nonobstructive and obstructive coronary artery disease. Finally, we discuss the role of CMD as a potential target for novel interventions beyond conventional approaches, representing a new frontier in cardiovascular disease reduction. Coronary microvascular disease (CMD) refers to the subset of disorders affecting the structure and function of the coronary microcirculation, is prevalent in patients across a broad spectrum of cardiovascular risk factors and associated with increased risk of adverse events. Contemporary evidence supports that most patients with CMD also have macrovessel atherosclerosis. In this state-of-the-art review, the authors summarize what is known about the pathophysiology of CMD, provide an update of diagnostic testing strategies, classify CMD into clinical phenotypes according to severity and coexistence with atherosclerosis, and discuss its role as a potential target for novel interventions.
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影响因子：
37.8
作者：
Dagenais, Gilles R.;Lu, Jiang;Frye, Robert L.
通讯作者：
Frye, Robert L.
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SCHWAIGER, M
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通讯作者：
Wijns, W
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