Inflammation and coronary microvascular disease: relationship, mechanism and treatment

Zehui Guo, Zhihua Yang, Zhi-Jian Song, Zhenzhen Li, Yang Xiao, Yuhang Zhang, Tao Wen, Gui-Xia Pan, Haowei Xu, Xiaodi Sheng, Guowang Jiang, Liping Guo, Yi Wang
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Abstract

Coronary microvascular disease (CMVD) is common in patients with cardiovascular risk factors and is linked to an elevated risk of adverse cardiovascular events. Although modern medicine has made significant strides in researching CMVD, we still lack a comprehensive understanding of its pathophysiological mechanisms due to its complex and somewhat cryptic etiology. This greatly impedes the clinical diagnosis and treatment of CMVD. The primary pathological mechanisms of CMVD are structural abnormalities and/or dysfunction of coronary microvascular endothelial cells. The development of CMVD may also involve a variety of inflammatory factors through the endothelial cell injury pathway. This paper first reviews the correlation between the inflammatory response and CMVD, then summarizes the possible mechanisms of inflammatory response in CMVD, and finally categorizes the drugs used to treat CMVD based on their effect on the inflammatory response. We hope that this paper draws attention to CMVD and provides novel ideas for potential therapeutic strategies based on the inflammatory response.
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炎症与冠状动脉微血管疾病:关系、机制与治疗
冠状动脉微血管疾病(CMVD)常见于有心血管风险因素的患者,并与不良心血管事件的风险升高有关。尽管现代医学在研究冠状动脉微血管病变方面取得了长足的进步,但由于其病因复杂且有些神秘,我们对其病理生理机制仍缺乏全面的了解。这极大地阻碍了 CMVD 的临床诊断和治疗。CMVD 的主要病理机制是冠状动脉微血管内皮细胞的结构异常和/或功能障碍。CMVD 的发生还可能涉及多种炎症因子通过内皮细胞损伤途径的作用。本文首先回顾了炎症反应与 CMVD 之间的相关性,然后总结了 CMVD 中炎症反应的可能机制,最后根据其对炎症反应的影响对用于治疗 CMVD 的药物进行了分类。我们希望本文能引起人们对 CMVD 的关注,并为基于炎症反应的潜在治疗策略提供新的思路。
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