Coronary microvascular dysfunction in heart failure patients

Coronary microcirculation has multiple layers of autoregulatory function to maintain resting flow and augment hyperemic flow in response to myocardial demands. Functional or structural alterations in the coronary microvascular function are frequently observed in patients with heart failure with pres...

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Published inFrontiers in cardiovascular medicine Vol. 10; p. 1153994
Main Authors Toya, Takumi, Nagatomo, Yuji, Ikegami, Yukinori, Masaki, Nobuyuki, Adachi, Takeshi
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 02.06.2023
Subjects
Cardiovascular Medicine
coronary flow reserve
coronary microvascular dysfunction
coronary physiology
heart failure with preserved ejection fraction
heart failure with reduced ejection fraction
coronary flow reserve
heart failure with preserved ejection fraction
coronary microvascular dysfunction
heart failure with reduced ejection fraction
coronary physiology
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Summary:Coronary microcirculation has multiple layers of autoregulatory function to maintain resting flow and augment hyperemic flow in response to myocardial demands. Functional or structural alterations in the coronary microvascular function are frequently observed in patients with heart failure with preserved or reduced ejection fraction, which may lead to myocardial ischemic injury and resultant worsening of clinical outcomes. In this review, we describe our current understanding of coronary microvascular dysfunction in the pathogenesis of heart failure with preserved and reduced ejection fraction.
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Abbreviations AF, atrial fibrillation; CAD, coronary artery disease; CBF, coronary blood flow; CHIP, clonal hematopoiesis of indeterminate potential; CMD, coronary microvascular dysfunction; CFR, coronary flow reserve; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; LVEF, left ventricular ejection fraction; PCI, percutaneous coronary intervention; PAWP, pulmonary artery wedge pressure.
Reviewed by: Ilkka HA Heinonen, University of Turku, Finland
Edited by: Branko Dusan Beleslin, Institute for Cardiovascular Diseases, Clinical Center of Serbia, Serbia
ORCID Takumi Toya orcid.org/0000-0002-4681-2798
ISSN:2297-055X
2297-055X
DOI:10.3389/fcvm.2023.1153994