Title:Coronary Microvascular Dysfunction and Heart Failure with Preserved
Ejection Fraction - implications for Chronic Inflammatory Mechanisms
Volume: 18
Issue: 2
Author(s): Katie Anne Fopiano, Sawan Jalnapurkar, Alec C. Davila, Vishal Arora*Zsolt Bagi*
Affiliation:
- Division of
Cardiology, Department of Medicine, Medical College of Georgia, Augusta University Augusta, GA 30912, USA
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Keywords:
Heart failure, preserved ejection fraction, microvascular dysfunction, inflammation, oxidative stress, coronary arteries.
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 HFpEF.
Few recent studies have evaluated the role of the hyaluronan-CD44 axis in inflammation-related
cardiovascular pathologies, thus warranting further investigations. This review article summarizes
current evidence for the role of CMD in the development of HFpEF, focusing on molecular
mediators of chronic proinflammatory as well as oxidative stress mechanisms and possible therapeutic
approaches to consider for treatment and prevention.
