The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey
Heart failure with preserved ejection fraction (HFpEF) represents an entity with complex pathophysiologic pathways, among which coronary microvascular dysfunction (CMD) is believed to be an important orchestrator. Research in the field of CMD has highlighted impaired vasoreactivity, capillary rarefa...
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| Veröffentlicht in: | Heart failure reviews 2025-01, Vol.30 (1), p.75-88 |
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| creator | Dimitriadis, Kyriakos Theofilis, Panagiotis Koutsopoulos, Georgios Pyrpyris, Nikolaos Beneki, Eirini Tatakis, Fotis Tsioufis, Panagiotis Chrysohoou, Christina Fragkoulis, Christos Tsioufis, Konstantinos |
| description | Heart failure with preserved ejection fraction (HFpEF) represents an entity with complex pathophysiologic pathways, among which coronary microvascular dysfunction (CMD) is believed to be an important orchestrator. Research in the field of CMD has highlighted impaired vasoreactivity, capillary rarefaction, and inflammation as potential mediators of its development. CMD can be diagnosed via several noninvasive methods including transthoracic echocardiography, cardiac magnetic resonance, and positron emission tomography. Moreover, invasive methods such as coronary flow reserve and index of microcirculatory resistance are commonly employed in the assessment of CMD. As far as the association between CMD and HFpEF is concerned, numerous studies have highlighted the coexistence of CMD in the majority of HFpEF patients. Additionally, patients affected by both conditions may be facing an adverse prognosis. Finally, there is limited evidence suggesting a beneficial effect of renin-angiotensin-aldosterone system blockers, ranolazine, and sodium-glucose cotransporter-2 inhibitors in CMD, with further evidence being awaited regarding the impact of other pharmacotherapies such as anti-inflammatory agents. |
| doi_str_mv | 10.1007/s10741-024-10445-3 |
| format | Article |
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Research in the field of CMD has highlighted impaired vasoreactivity, capillary rarefaction, and inflammation as potential mediators of its development. CMD can be diagnosed via several noninvasive methods including transthoracic echocardiography, cardiac magnetic resonance, and positron emission tomography. Moreover, invasive methods such as coronary flow reserve and index of microcirculatory resistance are commonly employed in the assessment of CMD. As far as the association between CMD and HFpEF is concerned, numerous studies have highlighted the coexistence of CMD in the majority of HFpEF patients. Additionally, patients affected by both conditions may be facing an adverse prognosis. 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Theofilis, Panagiotis ; Koutsopoulos, Georgios ; Pyrpyris, Nikolaos ; Beneki, Eirini ; Tatakis, Fotis ; Tsioufis, Panagiotis ; Chrysohoou, Christina ; Fragkoulis, Christos ; Tsioufis, Konstantinos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-27f01ab51688b9eef6c8e2762ba3e53d6c0be1609ce4ee4f9f0d0906b64a9e203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Aldosterone</topic><topic>Angiotensin</topic><topic>Anti-inflammatory agents</topic><topic>Cardiology</topic><topic>Coexistence</topic><topic>Congestive heart failure</topic><topic>Coronary artery disease</topic><topic>Coronary Circulation - physiology</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Coronary Vessels - physiopathology</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microcirculation - physiology</topic><topic>Microvasculature</topic><topic>Positron emission tomography</topic><topic>Prognosis</topic><topic>Renin</topic><topic>Review</topic><topic>Sodium-glucose cotransporter</topic><topic>Stroke Volume - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dimitriadis, Kyriakos</creatorcontrib><creatorcontrib>Theofilis, Panagiotis</creatorcontrib><creatorcontrib>Koutsopoulos, Georgios</creatorcontrib><creatorcontrib>Pyrpyris, Nikolaos</creatorcontrib><creatorcontrib>Beneki, Eirini</creatorcontrib><creatorcontrib>Tatakis, Fotis</creatorcontrib><creatorcontrib>Tsioufis, Panagiotis</creatorcontrib><creatorcontrib>Chrysohoou, Christina</creatorcontrib><creatorcontrib>Fragkoulis, Christos</creatorcontrib><creatorcontrib>Tsioufis, Konstantinos</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Heart failure reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dimitriadis, Kyriakos</au><au>Theofilis, Panagiotis</au><au>Koutsopoulos, Georgios</au><au>Pyrpyris, Nikolaos</au><au>Beneki, Eirini</au><au>Tatakis, Fotis</au><au>Tsioufis, Panagiotis</au><au>Chrysohoou, Christina</au><au>Fragkoulis, Christos</au><au>Tsioufis, Konstantinos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey</atitle><jtitle>Heart failure reviews</jtitle><stitle>Heart Fail Rev</stitle><addtitle>Heart Fail Rev</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>30</volume><issue>1</issue><spage>75</spage><epage>88</epage><pages>75-88</pages><issn>1573-7322</issn><issn>1382-4147</issn><eissn>1573-7322</eissn><abstract>Heart failure with preserved ejection fraction (HFpEF) represents an entity with complex pathophysiologic pathways, among which coronary microvascular dysfunction (CMD) is believed to be an important orchestrator. Research in the field of CMD has highlighted impaired vasoreactivity, capillary rarefaction, and inflammation as potential mediators of its development. CMD can be diagnosed via several noninvasive methods including transthoracic echocardiography, cardiac magnetic resonance, and positron emission tomography. Moreover, invasive methods such as coronary flow reserve and index of microcirculatory resistance are commonly employed in the assessment of CMD. As far as the association between CMD and HFpEF is concerned, numerous studies have highlighted the coexistence of CMD in the majority of HFpEF patients. Additionally, patients affected by both conditions may be facing an adverse prognosis. 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| ispartof | Heart failure reviews, 2025-01, Vol.30 (1), p.75-88 |
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| subjects | Aldosterone Angiotensin Anti-inflammatory agents Cardiology Coexistence Congestive heart failure Coronary artery disease Coronary Circulation - physiology Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Echocardiography Ejection fraction Heart failure Heart Failure - drug therapy Heart Failure - physiopathology Humans Medicine Medicine & Public Health Microcirculation - physiology Microvasculature Positron emission tomography Prognosis Renin Review Sodium-glucose cotransporter Stroke Volume - physiology |
| title | The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey |
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