Research
Mixed
Coronary Microvascular Dysfunction (CMD) is a significant predictor of adverse cardiovascular events, heart failure with preserved ejection fraction (HFpEF), and mortality in diabetic patients, even in the absence of obstructive coronary artery disease.
Normal results on a standard angiogram (looking for big blockages) do not guarantee heart health if you have diabetes. Microvascular dysfunction can still cause heart failure and heart attacks. Monitoring for symptoms like shortness of breath and chest pain is crucial, as these may signal microvascular issues.
GoodSupportsHIGH confidence
DM patients with CMD have a poorer prognosis, with a higher rate of hospitalization for heart failure (HF) and a greater risk of sudden cardiac death and myocardial infarction than those without, even in the absence of obstructive coronary artery disease (CAD)... Myocardial flow reserve (MFR), a significant marker of coronary microvascular dysfunction, emerged as a predictor of adverse CV events and HF with preserved ejection fraction (HFpEF).
Why this rating
Supported by multiple clinical studies and retrospective cross-sectional data cited.
Source
Coronary Microvascular Dysfunction in Diabetes Mellitus: Pathogenetic Mechanisms and Potential Therapeutic Options
Teresa Salvatore et al. · Biomedicines · 2022
DOI 10.3390/biomedicines10092274
narrative_reviewCited 89×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Hyperglycemia and insulin resistance drive Coronary Microvascular Dysfunction (CMD) through oxidative stress, inflammation, and reduced nitric oxide (NO) bioavailability, leading to endothelial dysfunction.Strong
- GLP-1-based therapies and SGLT2 inhibitors provide protective effects on the coronary microvascular compartment in diabetic patients, addressing coronary microvascular dysfunction (CMD).Moderate
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