The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction
Heart failure with preserved ejection fraction (HFpEF) is a common condition with few effective therapies and hence represents a major healthcare burden. The clinical syndrome of HFpEF can be caused by varying pathophysiological processes, with coronary microvascular dysfunction (CMD) proposed as on...
| 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/S2666602224000302 |
| _version_ | 1827277439963758592 |
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| author | Becker Al-Khayatt Divaka Perera Haseeb Rahman |
| author_facet | Becker Al-Khayatt Divaka Perera Haseeb Rahman |
| author_sort | Becker Al-Khayatt |
| collection | DOAJ |
| description | Heart failure with preserved ejection fraction (HFpEF) is a common condition with few effective therapies and hence represents a major healthcare burden. The clinical syndrome of HFpEF can be caused by varying pathophysiological processes, with coronary microvascular dysfunction (CMD) proposed as one of the aetiologies, although confirming causality has been challenging. CMD is characterised by the inability of the coronary vasculature to augment blood flow in response to a physiological stressor and has been established as the driver of angina in patients with non-obstructed coronaries (ANOCA), and this has subsequently led to efficacious endotype-directed therapies. CMD is also highly prevalent among sufferers of HFpEF and may represent a novel treatment target for this particular endotype of this condition. This review aims to discuss the role of the microcirculation in the healthy heart how it's dysfunction may precipitate HFpEF and explore the current diagnostic tools available. We also discuss the gaps in evidence and where we believe future research should be focussed. |
| first_indexed | 2024-04-24T07:22:19Z |
| format | Article |
| id | doaj.art-aa6987d64a2e4668b88efb6fa6d73232 |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-24T07:22:19Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-aa6987d64a2e4668b88efb6fa6d732322024-04-21T04:14:32ZengElsevierAmerican Heart Journal Plus2666-60222024-05-0141100387The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fractionBecker Al-Khayatt0Divaka Perera1Haseeb Rahman2The British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, United KingdomThe British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, United KingdomCorresponding author at: School of Cardiovascular Medicine and Sciences, King's College London, United Kingdom.; The British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, United KingdomHeart failure with preserved ejection fraction (HFpEF) is a common condition with few effective therapies and hence represents a major healthcare burden. The clinical syndrome of HFpEF can be caused by varying pathophysiological processes, with coronary microvascular dysfunction (CMD) proposed as one of the aetiologies, although confirming causality has been challenging. CMD is characterised by the inability of the coronary vasculature to augment blood flow in response to a physiological stressor and has been established as the driver of angina in patients with non-obstructed coronaries (ANOCA), and this has subsequently led to efficacious endotype-directed therapies. CMD is also highly prevalent among sufferers of HFpEF and may represent a novel treatment target for this particular endotype of this condition. This review aims to discuss the role of the microcirculation in the healthy heart how it's dysfunction may precipitate HFpEF and explore the current diagnostic tools available. We also discuss the gaps in evidence and where we believe future research should be focussed.http://www.sciencedirect.com/science/article/pii/S2666602224000302HFpEFCMDANOCA |
| spellingShingle | Becker Al-Khayatt Divaka Perera Haseeb Rahman The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction American Heart Journal Plus HFpEF CMD ANOCA |
| title | The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| title_full | The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| title_fullStr | The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| title_full_unstemmed | The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| title_short | The role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| title_sort | role of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved ejection fraction |
| topic | HFpEF CMD ANOCA |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224000302 |
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