Targeting the Vessel Underdogs: Therapeutic Approaches for Microvessel Dysfunction in the Heart.

From an obscure and overlooked beginning, the function of the microvessels in the heart has received increasing attention after the Women's Ischemia Syndrome Evaluation study concluded roughly a decade ago. This review defines the contribution of the coronary microcirculation in the development of heart disease and focuses on the therapeutic methods to reverse coronary microvascular dysfunction. Tissue engineering approaches in the past have largely neglected vascular cells in the attempts to design augmented myocardial tissue, but groups are now making advances that incorporate a functional microcirculation with cardiomyocytes that may advance this line of research. This review covers the definition and classification of coronary microvascular disease, as well as the successful (and unsuccessful) therapeutic approaches in the literature.