Invasive coronary vasoreactivity testing to diagnose microvascular dysfunction in women.

Fundamental gaps still exist in our understanding of cardiovascular disease in women. Women are more likely to suffer from coronary heart disease due to a higher prevalence of very old age relative to men. Women tend to be protected from the development and complications of coronary artery disease (CAD) at younger ages, perhaps due to the beneficial effects of estrogen on the vasculature. A number of sex-related physiological differences might affect coronary vascular function, including sex-based variations in vessel anatomy, biomechanical properties (1), and endothelial function. The vascular endothelium, in particular, plays a key protective role in terms of preventing thrombosis, smooth muscle cell proliferation, and vasoconstriction.