Myocardial ischemia and coronary disease in heart failure.
Beniamino R PagliaroFrancesco CannataGiulio Giuseppe StefaniniLeonardo BolognesePublished in: Heart failure reviews (2020)
Heart failure is a complex clinical syndrome and represents the final path of numerous heart diseases. Coronary artery disease is recognized as the primary risk factor for heart failure development, being the main etiological factor in more than 50% of heart failure patients in North America and Europe. Regardless of overt coronary artery disease, myocardial ischemia is a common finding in failing hearts, likely due to structural or functional coronary circulation alterations. Ischemia is a self-propagating process which irreversibly impairs the cardiac function and negatively impacts prognosis. Thus, a better and thorough understanding of myocardial ischemia pathophysiology in heart failure would likely lead to significantly improved outcomes in these patients. This review aims to describe the mechanisms of myocardial ischemia and coronary artery disease in heart failure, focusing on coronary circulation dysfunctions due to increased parietal stress or non-obstructive coronary disease, and discussing the association and management of coronary artery disease in patients with heart failure.
Keyphrases
- coronary artery disease
- heart failure
- left ventricular
- percutaneous coronary intervention
- cardiovascular events
- coronary artery bypass grafting
- aortic stenosis
- cardiac resynchronization therapy
- ejection fraction
- acute heart failure
- coronary artery
- newly diagnosed
- type diabetes
- working memory
- adipose tissue
- insulin resistance
- metabolic syndrome
- cardiovascular disease
- transcatheter aortic valve replacement
- heat stress
- patient reported outcomes