There is a growing recognition that disorders affecting the structure and function of the coronary microcirculation can act as key mediators of patient symptoms and prognosis. The subset of disorders affecting the microcirculation is termed coronary microvascular disease (CMD), which is expressed as either the inability of the coronary arteries to dilate appropriately to meet myocardial oxygen demand and/or as the abrupt reduction in coronary blood flow related to coronary spasm.

For the past 2 decades, CMD has been actively investigated in various cardiac conditions across a broad spectrum of cardiovascular risk factors. ^, Microvascular dysfunction is triggered by low-grade systemic inflammation induced by conventional cardiovascular risk factors, including hypertension, diabetes, obesity, dyslipidemia, and older age. ^, This spectrum of abnormalities may likely be magnified by the presence of epicardial atherosclerosis.

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