TY - JOUR
T1 - Sex-Specific Aspects in the Pathophysiology and Imaging of Coronary Macro- and Microvascular Disease
AU - Groepenhoff, Floor
AU - Bots, Sophie H
AU - Kessler, Elise L
AU - Sickinghe, Ariane A
AU - Eikendal, Anouk L M
AU - Leiner, Tim
AU - den Ruijter, Hester M
N1 - Funding Information:
This study was funded by the Dutch Heart Foundation (2013T084, Queen of Hearts Program) and by ZonMw grant (849100003, Reviews en Kennissyntheses Gender en Gezondheid).
Publisher Copyright:
© 2019, The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/2
Y1 - 2020/2
N2 - Sex differences in coronary artery disease (CAD) are well established, with women presenting with non-obstructive CAD more often than men do. However, recent evidence has identified coronary microvascular dysfunction as the underlying cause for cardiac complaints, yet sex-specific prevalence numbers are inconclusive. This review summarises known sex-specific aspects in the pathophysiology of both macro- and microvascular dysfunction and identifies currently existing knowledge gaps. In addition, this review describes current diagnostic approaches and whether these should take underlying sex differences into account by, for example, using different techniques or cut-off values for women and men. Future research into both innovation of imaging techniques and perfusion-related sex differences is needed to fill evidence gaps and enable the implementation of the available knowledge in daily clinical practice.
AB - Sex differences in coronary artery disease (CAD) are well established, with women presenting with non-obstructive CAD more often than men do. However, recent evidence has identified coronary microvascular dysfunction as the underlying cause for cardiac complaints, yet sex-specific prevalence numbers are inconclusive. This review summarises known sex-specific aspects in the pathophysiology of both macro- and microvascular dysfunction and identifies currently existing knowledge gaps. In addition, this review describes current diagnostic approaches and whether these should take underlying sex differences into account by, for example, using different techniques or cut-off values for women and men. Future research into both innovation of imaging techniques and perfusion-related sex differences is needed to fill evidence gaps and enable the implementation of the available knowledge in daily clinical practice.
KW - Coronary artery disease
KW - Coronary flow reserve (CFR)
KW - Coronary imaging
KW - Fractional flow reserve
KW - Index of microcirculatory resistance
KW - Microvascular disease
KW - Microvascular dysfunction
KW - Sex differences
UR - http://www.scopus.com/inward/record.url?scp=85072026446&partnerID=8YFLogxK
U2 - 10.1007/s12265-019-09906-0
DO - 10.1007/s12265-019-09906-0
M3 - Review article
C2 - 31471830
SN - 1937-5387
VL - 13
SP - 39
EP - 46
JO - Journal of Cardiovascular Translational Research
JF - Journal of Cardiovascular Translational Research
IS - 1
ER -