Abstract
Myocardial blood flow (MBF) abnormalities, despite the presence of angiographically normal coronary arteries, have been documented in patients with heart failure due to idiopathic dilated cardiomyopathy (DCM). In particular, a reduction in MBF at rest [1] and/or in response to either metabolic [2] or pharmacologic vasodilating stimuli [3] has been reported. The cause-effect relationship between MBF abnormalities and ventricular dysfunction in DCM, however, is not fully elucidated. An intriguing hypothesis, coming out from the recent recognition of functional abnormalities of the coronary microcirculation in these patients [4–6], points to the relevance of coronary microvascular disease as a primary pathogenetic process leading to progressive ventricular dysfunction. Further testing of this hypothesis implies the demonstration that: 1) in advanced DCM, MBF abnormalities cannot be fully ascribed to the effects of structural and hemodynamic derangement of the myocardium; 2) coronary microvascular dysfunction may be detected also in early stage DCM and may predict progressive deterioration of ventricular function and worse prognosis.
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Neglia, D. et al. (1998). Pathophysiologic Role of Coronary Microcirculatory Impairment in Dilated Cardiomyopathy. In: Camerini, F., Gavazzi, A., De Maria, R. (eds) Advances in Cardiomyopathies. Springer, Milano. https://doi.org/10.1007/978-88-470-2155-6_18
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DOI: https://doi.org/10.1007/978-88-470-2155-6_18
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