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Cardiovascular Research Advance Access originally published online on May 29, 2008
Cardiovascular Research 2008 80(2):165-174; doi:10.1093/cvr/cvn136
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings

Axel R. Pries1,2, Helmut Habazettl1,2, Giuseppe Ambrosio3, Peter Riis Hansen4, Juan Carlos Kaski5, Volker Schächinger6, Harald Tillmanns7, Giuseppe Vassalli8, Isabella Tritto3, Michael Weis9, Cor de Wit10 and Raffaele Bugiardini11,*

1 Department of Physiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Arnimallee 22, D-14195 Berlin, Germany
2 Deutsches Herzzentrum Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
3 Division of Cardiology, University of Perugia School of Medicine, Ospedale Silvestrini, 06156 Perugia, Italy
4 Department of Cardiology P, Kas Gentofte, 2900 Hellerup, Denmark
5 Cardiac and Vascular Sciences, St George’s, University of London, London SW17 0RE, UK
6 Med. Klinik IV, JWG-Universität Frankfurt, 60590 Frankfurt, Germany
7 Abt. Innere Medizin, Zentrum für Innere Medizin, Gießen, Germany
8 Division de Cardiologie, CHUV, 1011 Lausanne, Switzerland
9 Med. Klinik u. Poliklinik I, LMU München, Klinikum Großhadern, Munich, Germany
10 Institut für Physiologie, Universität zu Lübeck, Lübeck, Germany
11 Dipartimento di Medicina Interna, Policlinico S. Orsola, 40138 Bologna, Italy

* Corresponding author. Tel/fax: +39 051 347290. E-mail address: raffaele.bugiardini{at}unibo.it; rabugi{at}netscape.net

Obstructive disease of the large coronary arteries is the prominent cause for angina pectoris. However, angina may also occur in the absence of significant coronary atherosclerosis or coronary artery spasm, especially in women. Myocardial ischaemia in these patients is often associated with abnormalities of the coronary microcirculation and may thus represent a manifestation of coronary microvascular disease (CMD). Elucidation of the role of the microvasculature in the genesis of myocardial ischaemia and cardiac damage—in the presence or absence of obstructive coronary atherosclerosis—will certainly result in more rational diagnostic and therapeutic interventions for patients with ischaemic heart disease. Specifically targeted research based on improved assessment modalities is needed to improve the diagnosis of CMD and to translate current molecular, cellular, and physiological knowledge into new therapeutic options.

KEYWORDS Coronary microvascular disease; Microvascular angina; Plethysmography; Laser Doppler flux; Iontophoresis; Intravital microscopy

Time for primary review: 23 days


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