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Biomolecules
Volume 15
Issue 2
10.3390/biom15020177
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

The Role of Circulating Biomarkers in Patients with Coronary Microvascular Disease

by
Rossella Quarta
1,2,
Giovanni Martino
3,
Letizia Rosa Romano
2,3,
Giovanni Lopes
1,
Francesco Fabio Greco
4,
Carmen Anna Maria Spaccarotella
5,
Ciro Indolfi
1,
Antonio Curcio
1,2,*,† and
Alberto Polimeni
1,4,*,†
1
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
2
Division of Cardiology, Annunziata Hospital, 87100 Cosenza, Italy
3
Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
4
Division of Interventional Cardiology, Annunziata Hospital, 87100 Cosenza, Italy
5
Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, 80134 Naples, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomolecules 2025, 15(2), 177; https://doi.org/10.3390/biom15020177
Submission received: 30 December 2024 / Revised: 16 January 2025 / Accepted: 24 January 2025 / Published: 25 January 2025
(This article belongs to the Special Issue Molecular, Cellular, and Blood Biomarkers in Diagnosis, Prognosis, Monitoring, and Treatment)
Review Reports Versions Notes

Abstract

Coronary microvascular disease (CMD) comprises a spectrum of conditions characterized by the functional and structural abnormalities of coronary microcirculation, affecting vessels typically smaller than 500 μm. Despite its clinical significance as a contributor to myocardial ischemia, CMD frequently remains underdiagnosed due to the limitations of current diagnostic approaches. Invasive testing, including coronary reactivity assessment, is considered the gold standard, but it is resource-intensive and not always accessible. Non-invasive methods, such as positron emission tomography (PET) and transthoracic Doppler echocardiography (TTDE), offer alternatives but are limited by varying accuracy and accessibility. Amid these diagnostic challenges, there is increasing interest in circulating biomarkers as adjuncts in CMD evaluation. Biomarkers associated with endothelial dysfunction, inflammation, and oxidative stress, detectable through routine blood tests, may assist in CMD diagnosis, risk stratification, and therapeutic monitoring. These biomarkers can offer insights into CMD pathogenesis and enable early, non-invasive screening to identify patients who may benefit from more invasive investigations. This narrative review examines studies assessing biomarkers in CMD patients with diagnoses confirmed through invasive techniques. Our objective is to focus on circulating biomarkers linked to the invasive evaluation of coronary microcirculation, aiming to advance the understanding of the underlying mechanisms of this prevalent condition and enhance diagnostic accuracy and the clinical management of affected patients.
Keywords: circulating biomarkers; coronary microvascular dysfunction (CMD); coronary flow reserve (CFR); index of microvascular resistance (IMR) circulating biomarkers; coronary microvascular dysfunction (CMD); coronary flow reserve (CFR); index of microvascular resistance (IMR)

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MDPI and ACS Style

Quarta, R.; Martino, G.; Romano, L.R.; Lopes, G.; Greco, F.F.; Spaccarotella, C.A.M.; Indolfi, C.; Curcio, A.; Polimeni, A. The Role of Circulating Biomarkers in Patients with Coronary Microvascular Disease. Biomolecules 2025, 15, 177. https://doi.org/10.3390/biom15020177

AMA Style

Quarta R, Martino G, Romano LR, Lopes G, Greco FF, Spaccarotella CAM, Indolfi C, Curcio A, Polimeni A. The Role of Circulating Biomarkers in Patients with Coronary Microvascular Disease. Biomolecules. 2025; 15(2):177. https://doi.org/10.3390/biom15020177

Chicago/Turabian Style

Quarta, Rossella, Giovanni Martino, Letizia Rosa Romano, Giovanni Lopes, Francesco Fabio Greco, Carmen Anna Maria Spaccarotella, Ciro Indolfi, Antonio Curcio, and Alberto Polimeni. 2025. "The Role of Circulating Biomarkers in Patients with Coronary Microvascular Disease" Biomolecules 15, no. 2: 177. https://doi.org/10.3390/biom15020177

APA Style

Quarta, R., Martino, G., Romano, L. R., Lopes, G., Greco, F. F., Spaccarotella, C. A. M., Indolfi, C., Curcio, A., & Polimeni, A. (2025). The Role of Circulating Biomarkers in Patients with Coronary Microvascular Disease. Biomolecules, 15(2), 177. https://doi.org/10.3390/biom15020177

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