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Role of PET to evaluate coronary microvascular dysfunction in non-ischemic cardiomyopathies

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Abstract

Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis. However, whether CMD in non-ischemic cardiomyopathy is a cause or an effect of the underlying cardiomyopathic process, or whether it can be potentially modifiable with specific therapies, remains incompletely understood.

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Authors and Affiliations

  1. Division of Nuclear Medicine and Molecular Imaging, Brigham and Women’s Hospital, 70 Francis Street, Shapiro 5th Floor, Room 128, Boston, MA, 02115, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  2. Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  3. The Noninvasive Cardiovascular Imaging Program, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  4. Departments of Medicine (Cardiology) and Radiology, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  5. Cardiac Amyloidosis Program, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  6. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

  7. Heart & Vascular Center, Brigham and Women’s Hospital, Boston, MA, USA

    Paco E. Bravo, Marcelo F. Di Carli & Sharmila Dorbala

Authors
  1. Paco E. Bravo
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  2. Marcelo F. Di Carli
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  3. Sharmila Dorbala
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Corresponding author

Correspondence to Sharmila Dorbala.

Ethics declarations

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

Paco E. Bravo declares that he has no conflict of interest.

Marcelo Di Carli declares that he has no conflict of interest.

Sharmila Dorbala has received grants from the National Institutes of Health (R01 HL 130563) and the American Heart Association (16 CSA 28880004) and grants from Astellas Pharma.

Funding

This work was supported in part by a grant from the National Institutes of Health (1T32HL094301, Dr. Bravo) and (1R01HL130563, Dr. Dorbala).

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Bravo, P.E., Di Carli, M.F. & Dorbala, S. Role of PET to evaluate coronary microvascular dysfunction in non-ischemic cardiomyopathies. Heart Fail Rev 22, 455–464 (2017). https://doi.org/10.1007/s10741-017-9628-1

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