医学
冠状动脉疾病
心脏病学
内科学
心绞痛
内皮功能障碍
血管舒缩
病理生理学
部分流量储备
缺血
心肌梗塞
冠状动脉造影
作者
Nida Waheed,Suzette E. Elias-Smale,Waddah Malas,Angela H.E.M. Maas,Tara Sedlak,Jennifer A. Tremmel,Puja K. Mehta
出处
期刊:Cardiovascular Research
[Oxford University Press]
日期:2020-01-20
卷期号:116 (4): 829-840
被引量:68
摘要
Ischaemic heart disease is a leading cause of morbidity and mortality in both women and men. Compared with men, symptomatic women who are suspected of having myocardial ischaemia are more likely to have no obstructive coronary artery disease (CAD) on coronary angiography. Coronary vasomotor disorders and coronary microvascular dysfunction (CMD) have been increasingly recognized as important contributors to angina and adverse outcomes in patients with no obstructive CAD. CMD from functional and structural abnormalities in the microvasculature is associated with adverse cardiac events and mortality in both sexes. Women may be particularly susceptible to vasomotor disorders and CMD due to unique factors such as inflammation, mental stress, autonomic, and neuroendocrine dysfunction, which predispose to endothelial dysfunction and CMD. CMD can be detected with coronary reactivity testing and non-invasive imaging modalities; however, it remains underdiagnosed. This review focuses on sex differences in presentation, pathophysiologic risk factors, diagnostic testing, and prognosis of CMD.
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