References

rpcardio

Rational Pharmacotherapy in Cardiology

Рациональная Фармакотерапия в Кардиологии

1819-64462225-3653

«SILICEA-POLIGRAF» LLC

10.20996/1819-6446-2023-04-02

rpcardio-2605

Research Article

POINT OF VIEW

ТОЧКА ЗРЕНИЯ

Coronary Microvascular Dysfunction: Epidemiology, Clinical Presentation, Diagnosis and Treatment

Коронарная микрососудистая дисфункция: эпидемиология, клиника, диагностика и лечение

https://orcid.org/0000-0003-4168-7219

Трисветова

Е. Л.

Trisvetova

E. L.

Трисветова Евгения Леонидовна,

Минск

Eugenia L. Trisvetova,

Minsk

trisvet-47@mail.ru

Белорусский государственный медицинский университетБеларусьBelarusian State Medical UniversityBelarus

2023

28042023

192186196

2023

Трисветова Е.Л.

Trisvetova E.L.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.rpcardio.online/jour/article/view/2605

In a significant number of patients with symptoms of angina pectoris or myocardial infarction with ischemic changes in the myocardium, according to the results of instrumental research methods, there is no hemodynamically significant stenosis of the coronary arteries. In these cases, vasospastic angina or microvascular dysfunction is considered the cause of coronary heart disease. Coronary microvascular dysfunction is caused by several pathological mechanisms that cause structural and functional disorders in the microvascular bed of the heart. Clinical groups of coronary microvascular dysfunction include angina pectoris and myocardial ischemia without obstructive coronary artery disease (primary coronary microvascular dysfunction), in combination with coronary atherosclerosis, with myocardial damage and iatrogenic nature. Diagnostics of microvascular disorders is carried out on the basis of the results of non-invasive and invasive methods, which make it possible to clarify the nature of the changes and choose an effective nondrug and drug treatment. The prognosis for coronary microvascular dysfunction is poor, due to the development of cardiovascular complications and death, a high risk of disability, and a decrease in the quality of life of patients.

У значительного числа пациентов с симптомами стенокардии или инфаркта миокарда с ишемическими изменениями в миокарде по результатам инструментальных методов исследования отсутствует гемодинамически значимый стеноз коронарных артерий. В этих случаях как причину ишемической болезни сердца рассматривают вазоспастическую стенокардию или микрососудистую дисфункцию. Коронарная микрососудистая дисфункция (КМД) обусловлена несколькими патологическими механизмами, вызывающими структурные и функциональные нарушения в микрососудистом русле сердца. Клинические группы КМД включают стенокардию и ишемию миокарда без обструктивного поражения коронарных артерий (первичная КМД), в сочетании с обструктивным атеросклерозом коронарных сосудов, при поражении миокарда и ятрогенного характера. Диагностика микрососудистых нарушений проводится на основании результатов неинвазивных и инвазивных методов, позволяющих уточнить характер изменений и выбрать эффективное немедикаментозное и медикаментозное лечение. Прогноз при КМД неблагоприятный, обусловлен развитием сердечно-сосудистых осложнений и смерти, высоким риском инвалидности, снижением качества жизни пациентов.

микрососудистая дисфункциякоронарные артериимикрососудистая стенокардиядиагностикалечение

microvascular dysfunctioncoronary arteriesmicrovascular anginadiagnosticstreatment

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The authors declare that there are no conflicts of interest present.