Assessment and pathophysiology of microvascular disease: Recent progress and clinical implications

Stefano Masi, Damiano Rizzoni, Stefano Taddei, Robert Jay Widmer, Augusto C. Montezano, Thomas F. Lüscher, Ernesto L. Schiffrin, Rhian M. Touyz, Francesco Paneni, Amir Lerman, Gaetano A. Lanza, Agostino Virdis

Research output: Contribution to journalReview articlepeer-review

Abstract

The development of novel, non-invasive techniques and standardization of protocols to assess microvascular dysfunction have elucidated the key role of microvascular changes in the evolution of cardiovascular (CV) damage, and their capacity to predict an increased risk of adverse events. These technical advances parallel with the development of novel biological assays that enabled the ex vivo identification of pathways promoting microvascular dysfunction, providing novel potential treatment targets for preventing cerebral-CV disease. In this article, we provide an update of diagnostic testing strategies to detect and characterize microvascular dysfunction and suggestions on how to standardize and maximize the information obtained from each microvascular assay. We examine emerging data highlighting the significance of microvascular dysfunction in the development CV disease manifestations. Finally, we summarize the pathophysiology of microvascular dysfunction emphasizing the role of oxidative stress and its regulation by epigenetic mechanisms, which might represent potential targets for novel interventions beyond conventional approaches, representing a new frontier in CV disease reduction.

Original languageEnglish
Pages (from-to)2590-2604
Number of pages15
JournalEuropean Heart Journal
Volume42
Issue number26
DOIs
Publication statusPublished - Jul 7 2021

Keywords

  • Clinical manifestations
  • Epigenetics
  • Microvascular disease
  • Oxidative stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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