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CMD in Myocardial Diseases

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Coronary Microvascular Dysfunction

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Abstract

CMD has been documented in most patients with myocardial diseases, including HCM, dilated cardiomyopathy, aortic stenosis, myocarditis, Anderson-Fabry disease, and cardiac amyloidosis. In this setting CMD is mainly caused by structural alterations. The consequent reduction of CFR is responsible for effort-induced myocardial ischemia and angina. CMD can be severe enough to determine focal areas of myocardial necrosis. Recent data indicate that in patients with HCM or dilated cardiomyopathy the presence of focal areas of myocardial necrosis, detected by CMR, is associated with a worse prognosis, mainly driven by sudden death, probably caused by myocardial necrosis-related ventricular arrhythmias. This prognostic information is additive to that provided by traditional risk factors and can therefore improve the identification of patients who need ICD implantation.

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Authors and Affiliations

  1. Division of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Filippo Crea & Gaetano A. Lanza

  2. Division of Cardiovascular Medicine, “Vita e Salute” University and Istituto Scientifico San Raffaele, Via Olgettina, 60, 20132, Milan, Italy

    Paolo G. Camici

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Crea, F., Lanza, G.A., Camici, P.G. (2014). CMD in Myocardial Diseases. In: Coronary Microvascular Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-5367-0_5

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