Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review
The coronary vascular system has a unique structure and function that is adaptive to myocardial demand. It is composed of a continuous network of vessels receding in size from epicardial arteries to the microvascular circulation. Failure to meet myocardial demand results in ischemia, angina, and adv...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602224000326 |
| _version_ | 1797199847595442176 |
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| author | Razan Dankar Jad Wehbi Mohamad Montaser Atasi Samir Alam Marwan M. Refaat |
| author_facet | Razan Dankar Jad Wehbi Mohamad Montaser Atasi Samir Alam Marwan M. Refaat |
| author_sort | Razan Dankar |
| collection | DOAJ |
| description | The coronary vascular system has a unique structure and function that is adaptive to myocardial demand. It is composed of a continuous network of vessels receding in size from epicardial arteries to the microvascular circulation. Failure to meet myocardial demand results in ischemia, angina, and adverse myocardial outcomes. It is evident that 50 % of patients with angina have a non-obstructive coronary disease and 66 % of these patients have coronary microvascular dysfunction (CMD). The impact of CMD on the atria and ventricles is exhibited through its association with atrial fibrillation and distortion of ventricular repolarization. Ultimately, this influence increases the risk of mortality, morbidity, and sudden cardiac arrest. CMD serves as an independent risk for atrial fibrillation, increases ventricular electrical inhomogeneity, and contributes to the progression of cardiac disease. The underlying pathogenesis may be attributed to oxidative stress evident through reactive oxygen species, impaired vasoactive function, and structural disorders such as fibrotic changes. Myocardial ischemia, brought about by a demand-supply mismatch in CMD, may create a milieu for ventricular arrythmia and sudden cardiac arrest through distortion of ventricular repolarization parameters such as QT dispersion and corrected QT dispersion. |
| first_indexed | 2024-04-24T07:22:16Z |
| format | Article |
| id | doaj.art-a1aef0f253ee4100921948462805108a |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-24T07:22:16Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-a1aef0f253ee4100921948462805108a2024-04-21T04:14:33ZengElsevierAmerican Heart Journal Plus2666-60222024-05-0141100389Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature reviewRazan Dankar0Jad Wehbi1Mohamad Montaser Atasi2Samir Alam3Marwan M. Refaat4Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonDivision of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonDivision of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonDivision of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonCorresponding author.; Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonThe coronary vascular system has a unique structure and function that is adaptive to myocardial demand. It is composed of a continuous network of vessels receding in size from epicardial arteries to the microvascular circulation. Failure to meet myocardial demand results in ischemia, angina, and adverse myocardial outcomes. It is evident that 50 % of patients with angina have a non-obstructive coronary disease and 66 % of these patients have coronary microvascular dysfunction (CMD). The impact of CMD on the atria and ventricles is exhibited through its association with atrial fibrillation and distortion of ventricular repolarization. Ultimately, this influence increases the risk of mortality, morbidity, and sudden cardiac arrest. CMD serves as an independent risk for atrial fibrillation, increases ventricular electrical inhomogeneity, and contributes to the progression of cardiac disease. The underlying pathogenesis may be attributed to oxidative stress evident through reactive oxygen species, impaired vasoactive function, and structural disorders such as fibrotic changes. Myocardial ischemia, brought about by a demand-supply mismatch in CMD, may create a milieu for ventricular arrythmia and sudden cardiac arrest through distortion of ventricular repolarization parameters such as QT dispersion and corrected QT dispersion.http://www.sciencedirect.com/science/article/pii/S2666602224000326Coronary microvascular dysfunctionVentricular arrythmiaAtrial fibrillationRepolarization parametersSudden cardiac death |
| spellingShingle | Razan Dankar Jad Wehbi Mohamad Montaser Atasi Samir Alam Marwan M. Refaat Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review American Heart Journal Plus Coronary microvascular dysfunction Ventricular arrythmia Atrial fibrillation Repolarization parameters Sudden cardiac death |
| title | Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review |
| title_full | Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review |
| title_fullStr | Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review |
| title_full_unstemmed | Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review |
| title_short | Coronary microvascular dysfunction, arrythmias, and sudden cardiac death: A literature review |
| title_sort | coronary microvascular dysfunction arrythmias and sudden cardiac death a literature review |
| topic | Coronary microvascular dysfunction Ventricular arrythmia Atrial fibrillation Repolarization parameters Sudden cardiac death |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224000326 |
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