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The coronary microcirculation plays a cardinal role in regulating coronary blood flow to meet the changing metabolic demands of the myocardium. Coronary microvascular dysfunction (CMD) refers to structural and functional remodeling of the coronary microcirculation. CMD plays a role in the pathogenesis of obstructive and non-obstructive coronary syndromes as well as myocardial diseases, including heart failure with preserved ejection fraction (HFpEF). Despite recent diagnostic advancements, CMD is often under-appreciated in clinical practice, and may allow for the development of novel therapeutic targets. This review explores the diagnosis and pathogenic role of CMD across a range of cardiovascular diseases, its prognostic significance, and the current therapeutic landscape.
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http://dx.doi.org/10.3389/fcvm.2023.1111721 | DOI Listing |
J Thromb Thrombolysis
September 2025
Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
In this review, we aimed to evaluate Sonothrombolysis when combined with primary percutaneous coronary intervention (pPCI) in STEMI patients with regard to improving cardiac function and clinical outcomes. This study primarily assesses short-term efficacy outcomes, while long-term impacts, such as mortality, were not evaluated. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, Scopus, Cochrane Library, and Web of Science) to identify eligible studies reported up to November 2024.
View Article and Find Full Text PDFClin Res Cardiol
September 2025
Department of (Interventional) Cardiology, Thoraxcenter, Erasmus University Medical Center, Room Rg-628, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Background: Fractional flow reserve (FFR) for non-culprit lesions (NCLs) in patients with ST-elevation myocardial infarction (STEMI) can be influenced by temporary changes in microvascular resistance. Angiography-derived vessel fractional flow reserve (vFFR) has been tested as a less-invasive alternative.
Aims: The FAST STEMI II study aimed to assess the diagnostic performance of acute-setting vFFR vs.
JACC Case Rep
September 2025
Cardiovascular Diseases Section, Interdisciplinary Department of Medicine (DIM), University of Bari "Aldo Moro," Bari, Italy.
Background: Brugada syndrome (BrS) is a rare inherited arrhythmia disease carrying a variable risk of sudden cardiac death. Diagnosis requires the type 1 Brugada electrocardiographic pattern, which can either be spontaneous or induced by sodium channel-blocking drugs. Ranolazine is an antianginal drug acting on the late sodium current with emerging antiarrhythmic properties; no information is available on the safety of ranolazine use in patients with BrS.
View Article and Find Full Text PDFCureus
August 2025
Department of Internal Medicine, Babcock University Teaching Hospital, Ilishan-Remo, NGA.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a group of heterogeneous diseases with different pathological mechanisms. It is often under-recognized because of its diverse differential diagnoses like myocarditis, takotsubo cardiomyopathy, spontaneous coronary artery dissection (SCAD), coronary microvascular dysfunction, vasospasm, coronary erosion, and embolism. Evaluation with multimodality imaging including intravascular coronary imaging and cardiac magnetic resonance is often necessary to determine the underlying etiology and management.
View Article and Find Full Text PDFMedicine (Baltimore)
September 2025
Department of Cardiology, Jining Key Laboratory of Metabolic Cardiovascular Diseases, Institute of Cardiovascular Diseases of Jining Medical Research Academy, Jining No. 1 People's Hospital, Jining, Shandong, China.
Rationale: Myocardial infarction with nonobstructive coronary arteries (MINOCA) has diverse ischemic etiologies and has been defined by the absence of angiographically significant obstructive coronary artery disease. Blood transfusion has seldom been reported as a precipitating factor for MINOCA. Here, we present a rare case of transfusion-associated MINOCA in a young woman without underlying chronic conditions, aiming to raise clinical awareness of this uncommon yet important phenomenon and to explore its potential pathophysiological mechanisms.
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