Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy.
Center of Excellence in Cardiovascular Sciences, Isola Tiberina Hospital Gemelli Isola, 00186 Rome, Italy.
Int J Mol Sci. 2024 Jul 11;25(14):7628. doi: 10.3390/ijms25147628.
Coronary microvascular dysfunction (CMD) plays a crucial role across the spectrum of heart failure (HF) pathology, contributing to disease development, progression, and outcomes. The pathophysiological mechanisms linking CMD to HF are complex and still not completely understood and include chronic inflammation, oxidative stress, and neurohormonal activation. Despite the diagnostic and prognostic relevance in patients with HF, there is no specific therapeutic strategy targeting CMD to date. Moreover, the diagnosis of this clinical condition is challenging. In this review article, we aim to discuss the different clinical pathogenetic mechanisms linking CMD to HF across the different spectra of these diseases, their prognostic relevance, and the possible therapeutic targets along with the remaining knowledge gaps in the field.
冠状动脉微血管功能障碍（CMD）在心力衰竭（HF）病理的各个方面都起着关键作用，导致疾病的发展、进展和结果。将 CMD 与 HF 联系起来的病理生理机制很复杂，仍不完全清楚，包括慢性炎症、氧化应激和神经激素激活。尽管在 HF 患者中有诊断和预后意义，但迄今为止尚无针对 CMD 的特定治疗策略。此外，这种临床情况的诊断具有挑战性。在这篇综述文章中，我们旨在讨论将 CMD 与 HF 联系起来的不同临床发病机制，及其在不同疾病谱中的预后相关性，以及可能的治疗靶点以及该领域的遗留知识空白。
