Coronary Microvascular Dysfunction in Cardiomyopathies: Insights on Clinical and Prognostic Roles - PubMed

5 days ago

Coronary microvascular dysfunction (CMD) is a significant factor in ischemia and prognosis in non-ischemic cardiomyopathies.
CMD in dilated cardiomyopathy is linked to reduced myocardial blood flow, increased fibrosis, adverse remodeling, and worse outcomes.
In hypertrophic cardiomyopathy, CMD is common and multifactorial, associated with fibrosis, heart failure, and arrhythmias/sudden death.
Takotsubo syndrome shows acute and reversible CMD, with microvascular spasms as a key mechanism.
In arrhythmogenic right ventricular cardiomyopathy, preliminary data suggest impaired microvascular vasodilation due to autonomic abnormalities.
Infiltrative and storage diseases like amyloidosis and Anderson-Fabry disease show early CMD, contributing to symptoms and adverse outcomes.
Sarcoidosis involves microvascular inflammation, reducing coronary flow reserve and linked to events.
Targeted therapies for CMD are limited; current strategies include risk factor optimization and drugs modulating endothelial/metabolic function.
Integrating microcirculatory assessment improves risk stratification and may offer future therapeutic targets.

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