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Microvascular angina due to coronary microvascular dysfunction: pathophysiological mechanisms, diagnostic and treatment aspects

Authors: Afanasyeva M.A., Kubova M.Ch., Bulaeva N.I.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2025-19-2-172-182

For citation: Afanasyeva M.A., Kubova M.Ch., Bulaeva N.I. Microvascular angina due to coronary microvascular dysfunction: pathophysiological mechanisms, diagnostic and treatment aspects. Creative Cardiology. 2025; 19 (2): 172–182 (in Russ.). DOI: 10.24022/1997-3187-2025-19-2-172-182

Received / Accepted:  30.03.2025 / 15.04.2025

Keywords: microvascular angina microvascular dysfunction endothelial dysfunction



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Abstract

The diagnosis of myocardial ischemia caused by coronary microvascular dysfunction (CMD), particularly the diagnosis of microvascular angina, has gained more prominence in recent decades. Despite patients with such a diagnosis having a higher risk of adverse cardiovascular events, including myocardial infarction, stroke, the onset and progression of heart failure, and death, there are currently no unified guidelines for the diagnosis and treatment of this nosology, and the management strategy for this group of patients largely remains empirical. The aim of this review is to examine the mechanisms underlying microvascular dysfunction, diagnostic criteria, and treatment methods for myocardial ischemia associated with microvascular dysfunction.

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About Authors

  • Margarita A. Afanasyeva, Resident Physician, Cardiologist; ORCID
  • Maida Ch. Kubova, Researcher Cardiologist; ORCID
  • Naida I. Bulaeva, Cardiologist, Сand. Biol. Sci., Head of the Department of coordination and support of research activities; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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