The emerging pathological mechanism of coronary microvascular dysfunction: a narrative review

Abstract

Thirty to forty percent of patients undergoing angiography for chest pain and tightness show no abnormalities in the large coronary arteries. This phenomenon is particularly common among women, with more than 50% affected. Research has identified coronary microvascular dysfunction (CMD) as a key underlying cause; however, its pathological mechanisms remain poorly understood. In this article, we explore the relationship between CMD and coronary artery disease and summarize the current knowledge on the pathological origins of CMD, which include endothelial dysfunction, inflammation, oxidative stress, left ventricular hypertrophy and mitochondrial abnormalities. Special emphasis is placed on pathological mechanisms contributing to the higher incidence of CMD in women.

Keywords

Coronary microvascular dysfunction / pathological mechanism / endothelial remodeling / women / coronary artery disease

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