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Coronary Microvascular Dysfunction: Epidemiology, Pathophysiology, Diagnosis, and Treatment.

Created on 24 Jul 2026

Authors

Zhao Ge, MaoZe Zhang, Xujin Ning, Yijia Du, Lishuo Su, Xudong Wu, Jingyi Zhang, Tongzuo Liu, Xianliang Wang

Published in

MedComm. Volume 7. Issue 8. Pages e70875. Epub Jul 22, 2026.

Abstract

Coronary microvascular dysfunction (CMD) is a key contributor to myocardial ischemia and cardiovascular diseases. It is characterized by abnormalities of the coronary microvasculature, leading to impaired myocardial perfusion. Although CMD has a high prevalence in patients with nonobstructive coronary artery disease and is associated with adverse cardiovascular events, its pathogenesis has not yet been fully elucidated. Current diagnostic approaches combine noninvasive and invasive methods, but there remains a lack of effective targeted therapies. This review discusses the epidemiology, pathophysiology, diagnostic strategies, and treatment options for CMD, with a particular focus on the protective role of the neuregulin-1 (NRG-1)/v-erb-b2 erythroblastic leukemia viral oncogene homolog B (ErbB) signaling pathway. We initially outline how the NRG-1/ErbB pathway affects endothelial function, ventricular remodeling, oxidative stress, and myocardial angiogenesis, highlighting its potential as a therapeutic target. In addition, we explore emerging evidence that traditional Chinese medicine (TCM) interventions may regulate the NRG-1/ErbB axis to improve microvascular function and cardiac outcomes. Overall, this review deepens our understanding of the mechanisms underlying CMD and provides new avenues for integrated precision therapies, including TCM, with the aim of improving clinical management and prognosis in patients with CMD.

PMID:
42494468
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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