Coronary Microvascular Dysfunction

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

This book reviews the latest findings on epicardial coronary spasm and coronary microvascular dysfunction (CMD), important diseases for understanding coronary artery vasomotion abnormalities. The book chiefly consists of two major parts, each of which explores the epidemiology, pathophysiology, diagnosis and treatment of the diseases. The chapters present a range of experimental and clinical studies, including the editor’s life’s work on coronary spasm; how Rho-kinase activation plays an important role in connection with the disease; how chronic adventitial inflammation is a central pathophysiology of the spasm; the importance of Rho-kinase activation in the pathogenesis of CMD; how epicardial spasm and CMD frequently co-exist; and much more. Coronary Vasomotion Abnormalities will help practicing cardiologists, cardiac surgeons, vascular biologists and radiologists understand the latest issues concerning the clinical, interventional, and surgical management of these conditions, and offer these readers valuable insights into the effective treatment of microvascular angina.

Coronary Microvascular Obstruction in Acute Myocardial Infarction: From Mechanisms to Treatment provides a comprehensive understanding of the phenomenon of coronary microvascular obstruction (CMVO) that is the main limitation of reperfusion therapies in ST-elevation myocardial infarction. It provides in-depth coverage of the phenomenon of CMVO which heavily affects prognosis by increasing the risk of death and heart failure at follow-up. A first of its kind reference dedicated solely to this topic, it is appropriate for a wide audience, from researchers, to those who aid in the management, prevention and treatment of CMVO. Provides in-depth coverage of coronary microvascular obstruction (CMVO), spanning research, management, prevention and treatment Includes the most up-to-date information on CMVO as presented from top experts around the word Provides access to a companion website with extra material, including tables, additional references and instructional videos Gives extensive coverage on how to measure CMVO, including in-depth indexes that can be used to detect and quantify the phenomenon

This textbook focuses on the vascular biology and physiology that underlie vascular disorders in clinical medicine. Vascular biomedicine is a rapidly growing field as new molecular mechanisms of vascular health and disease are unraveled. Many of the major cardiovascular diseases including coronary artery disease, heart failure, stroke and vascular dementia are diseases of the vasculature. In addition vascular injury underpins conditions like kidney failure and cardiovascular complications of diabetes. This field is truly multidisciplinary involving scientists in many domains such as molecular and vascular biology, cardiovascular physiology and pharmacology and immunology and inflammation. Clinically, specialists across multiple disciplines are involved in the management of patients with vascular disorders, including cardiologists, nephrologists, endocrinologists, neurologists and vascular surgeons. This book covers a wide range of topics and provides an overview of the discipline of vascular biomedicine without aiming at in-depth reviews, but rather offering up-to-date knowledge organized in concise and structured chapters, with key points and pertinent references. The structure of the content provides an integrative and translational approach from basic science (e.g. stem cells) to clinical medicine (e.g. cardiovascular disease). The content of this book is targeted to those who are new in the field of vascular biology and vascular medicine and is ideal for medical students, graduate and postgraduate students, clinical fellows and academic clinicians with an interest in the vascular biology and physiology of cardiovascular disease and related pathologies.

This comprehensive reference book of coronary microcirculation broadly covers theoretical aspects, clinical cases and therapeutic considerations from an innovative perspective. Topics covered include: ischemic heart disease, silent cerebral damage, heart failure, left ventricular hypertrophy arrhythmias, and cerebral and renal microcirculation. Microcirculation: From Bench to Bedside underlines the clinical importance of addressing coronary microcirculation with relevant clinical examples that are often encountered by practitioners. It therefore provides a critical resource on microcirculation for both specialist and non-specialist practitioners.

Written by leading authorities in the field, Chest Pain with Normal Coronary Arteries comprehensively reviews the clinical presentation and the pathogenesis of the condition, as well as its management. This book provides a practical tool for the clinician and a bank of information and new ideas for research scientists and clinical researchers interested in understanding the causes and mechanisms of chest pain with normal coronary arteries. Whether the pain be of gastroenterologic, cardiac or endocrine in origin, the book focuses on effective diagnosis, treatment and management of different pathologies in patients. Chest Pain with Normal Coronary Arteries is an essential read for all clinicians involved in managing patients with chest pain, and those that should be aware of non-cardiac chest pain.

This book provides new perspectives on the pathogenesis of atherosclerosis. Chapters cover atherosclerosis risk factors, the effect of growth and aging on vascular architecture, and the crucial role the microvasculature plays in atherosclerosis development. Microvascular dysfunction would explain why the well-known risk factors actually put individuals at higher risk. This pathomechanism would also hold true not only for obstructive atheroma formation but also for aneurysmal dilatation as well as for aortic and peripheral artery dissection. When seen through this lens, novel preventive and therapeutic opportunities can be envisioned. Atherosclerosis Pathogenesis and Microvascular Dysfunction proposes a single unifying mechanism of atherosclerosis development and describes potential preventative and therapeutic avenues based on this concept. It therefore represents a timely and valuable resource for internal medicine, cardiology, angiology cardiovascular surgeons, pathology clinicians, researchers, trainees, and students.