Imaging Microvascular Dysfunction and Mechanisms for Female-Male Differences in CAD
| Autor: | K. Lance Gould, Richard L. Kirkeeide, Linh Bui, Monica B. Patel |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Comorbidity Coronary Artery Disease 030204 cardiovascular system & hematology Severity of Illness Index Coronary artery disease 03 medical and health sciences 0302 clinical medicine Sex Factors Predictive Value of Tests Risk Factors Internal medicine Coronary Circulation medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Endothelial dysfunction Healthcare Disparities Coronary atherosclerosis Aged medicine.diagnostic_test business.industry Microcirculation Myocardial Perfusion Imaging Health Status Disparities Middle Aged medicine.disease Prognosis Coronary Vessels Coronary arteries Stenosis medicine.anatomical_structure Positron emission tomography Cardiac PET Radiology Nuclear Medicine and imaging Microvessels Cardiology Female Radiology business Cardiology and Cardiovascular Medicine Perfusion Blood Flow Velocity |
| Zdroj: | JACC: Cardiovascular Imaging. 9(4):465-482 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2016.02.003 |
| Popis: | Microvascular dysfunction or disease is most commonly associated with diffuse epicardial coronary atherosclerosis and endothelial dysfunction, whereas it is less common as a distinct, separate, isolated pathophysiology. The different manifestations of coronary artery disease in women relate in part to their smaller coronary arteries, higher coronary blood flow, and higher endothelial shear stress, which have profound effects on endothelial function and development or resistance to atherosclerosis, its symptomatic presentation, outcomes, and treatment. The complex interactions of focal stenosis, diffuse epicardial atherosclerotic coronary narrowing, and microvascular dysfunction make definitive diagnosis and management difficult by use of standard noninvasive and invasive physiological and anatomic technologies. However, quantitative rest-stress myocardial perfusion, best documented by positron emission tomography, combined with clinical circumstances usually provides a definitive diagnosis to guide management, including vigorous risk factor management and revascularization for patients with physiologically severe epicardial stenosis by quantitative positron emission tomography. |
| Databáze: | OpenAIRE |
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