Coronary Microvascular Dysfunction and Heart Failure with Preserved Ejection Fraction-implications for Chronic Inflammatory Mechanisms

Katie Anne Fopiano, Sawan Jalnapurkar, Alec C. Davila, Vishal Arora, Zsolt Bagi

Research output: Contribution to journalArticlepeer-review

Abstract

Coronary Microvascular Dysfunction (CMD) is now considered one of the key underlying pathologies responsible for the development of both acute and chronic cardiac complications. It has been long recognized that CMD contributes to coronary no-reflow, which occurs as an acute complication during percutaneous coronary interventions. More recently, CMD was proposed to play a mechanistic role in the development of left ventricle diastolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Emerging evidence indicates that a chronic low-grade pro-inflammatory activation predisposes patients to both acute and chronic cardiovascular complications raising the possibility that pro-inflammatory mediators serve as a mechanistic link in HF-pEF. Few recent studies have evaluated the role of the hyaluronan-CD44 axis in inflammation-relat-ed cardiovascular pathologies, thus warranting further investigations. This review article sum-marizes current evidence for the role of CMD in the development of HFpEF, focusing on molecu-lar mediators of chronic proinflammatory as well as oxidative stress mechanisms and possible therapeutic approaches to consider for treatment and prevention.

Original languageEnglish (US)
Article numbere310821195986
Pages (from-to)6-14
Number of pages9
JournalCurrent Cardiology Reviews
Volume18
Issue number2
DOIs
StatePublished - Mar 2022
Externally publishedYes

Keywords

  • Heart failure
  • coronary arteries
  • inflammation
  • microvascular dysfunction
  • oxidative stress
  • preserved ejection fraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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