Bravo Paco E, Di Carli Marcelo F, Dorbala Sharmila
Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, 70 Francis Street, Shapiro 5th Floor, Room 128, Boston, MA, 02115, USA.
Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
Heart Fail Rev. 2017 Jul;22(4):455-464. doi: 10.1007/s10741-017-9628-1.
Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis. However, whether CMD in non-ischemic cardiomyopathy is a cause or an effect of the underlying cardiomyopathic process, or whether it can be potentially modifiable with specific therapies, remains incompletely understood.
冠状动脉微血管功能障碍（CMD）可由壁内和小冠状动脉水平的结构和功能异常引起，影响冠状动脉血流的自动调节，进而导致冠状动脉血流储备受损。CMD常与心外膜冠状动脉疾病共存，但也常见于各种形式的心脏病患者，包括扩张型、肥厚型和浸润性心肌病。CMD可能没有任何症状而未被注意到，或表现为心绞痛和/或呼吸困难，并导致心力衰竭的发生，甚至猝死，特别是当与心肌纤维化共存时。然而，非缺血性心肌病中的CMD是潜在心肌病过程的原因还是结果，或者它是否可以通过特定治疗得到潜在改善，目前仍未完全明确。
