Microvascular angina: Quo tendimus?

Abstract

Summary of known mechanisms that cause ischaemia with normal coronary arteries at the level of both the epicardial coronary arteries (coronary vasospasm and intramyocardial muscle bridging) and the coronary microcirculation [microvascular spasm, endothelial dysfunction, arteriolar remodelling, two endotypes of coronary microvascular dysfunction (structural due to failure to maximally vasodilate and functional due to exhausted vasodilatory capacity), and capillary rarefaction]. cMVD, coronary microvascular dysfunction; CBF, coronary blood flow; CFR, coronary flow reserve; hMR, hyperaemic index ofmicrocirculatory resistance.