Coronary microvascular dysfunction. An update

Translated title of the contribution: [Autom. eng. transl.] Coronary microvascular dysfunction. An update

Gaetano Antonio Lanza, Priscilla Lamendola, Pierpaolo Tarzia, Antonino Di Franco, Maria Milo, Marianna Laurito

Research output: Contribution to journalArticlepeer-review

Abstract

Several studies in the last years have shown that a dysfunction of coronary microcirculation may be responsible for abnormalities in coronary blood flow and some clinical pictures. Coronary microvascular dysfunction, in absence of other coronary artery abnormalities, can cause anginal symptoms, resulting in a condition named microvascular angina (MVA). MVA can occur in a chronic form, predominantly related to effort (stable MVA), more frequently referred as cardiac syndrome X, or in an acute form, most frequently ensuing at rest, which simulates an acute coronary syndrome (unstable MVA). The main abnormalities characterizing these two forms of MVA consist of an impaired vasodilation and an increased vasoconstriction of small resistive coronary arteries, respectively. The mechanisms responsible for stable MVA are still unclear, but seem to include, together with the known traditional cardiovascular risk factors, an abnormally increased cardiac adrenergic activity. The prognosis of stable MVA is good, but some patients have progressive worsening of symptoms. Clinical outcome of patients with unstable MVA is substantially unknown, as there are no specific studies about this population. Treatment of stable MVA includes traditional anti-ischemic drugs as first step; in case of persisting symptoms several other drugs have been proposed, including xanthine derivatives, ACE-inhibitors, statins and, in women, estrogens. Severe forms of intense constriction (or spasm) of small coronary arteries may cause transmural myocardial ischemia, as the microvascular form of variant angina and the tako-tsubo syndrome.
Translated title of the contribution[Autom. eng. transl.] Coronary microvascular dysfunction. An update
Original languageItalian
Pages (from-to)329-337
Number of pages9
JournalRECENTI PROGRESSI IN MEDICINA
Volume2011
Publication statusPublished - 2011

Keywords

  • CORONARY MICROVASCULAR DYSFUNCTION

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