Coronary Microvascular Dysfunction Symptoms & Treatment
What is Coronary Microvascular Dysfunction (CMD)?
Also known as Coronary Microvascular Disease, Microvascular Angina, Cardiac Syndrome X, Ischemic Heart Disease, Non-obstructive Coronary Artery Disease, Small Vessel Disease, Small Artery Disease, INOCA (Ischemia with No Obstructive Coronary Arteries)
Coronary microvascular dysfunction (CMD) is a disease that causes narrowing of the small blood vessels that are responsible for supplying oxygen-rich blood to the heart muscle. This decreases the amount of blood flow to the heart, leading to frequent chest pain (angina), affecting approximately 8.3 million people in the U.S. (1),(2); however, many people with CMD don’t even know they have it, as it is often unrecognized. In CMD patients, there is no accompanying corresponding narrowing of the large vessels supplying blood to the heart.
Clogging or narrowing of the arteries that supply blood to your heart can occur not only in your heart’s largest arteries (the coronary arteries), but also in your heart’s smaller blood vessels (the microvasculature). Coronary artery disease (CAD) involves plaque formation that can block blood flow.; however, in CMD, the heart’s small blood vessels do not have plaque, but have damage to the inner walls of the blood vessels. This damage can lead to spasms and decreased blood flow to the heart muscle, causing chronic chest pain (angina), shortness of breath, fatigue, heart attack, and heart failure.(3) The condition is most common among women, especially after menopause, but men can also have CMD.
What are the Signs and Symptoms of CMD?
The most common symptom of CMD is chest pain, or angina, lasting more than 10-30 minutes. Other signs and symptoms of CMD include:
- shortness of breath
- sleep problems
- lack of energy
What are the available treatment options of CMD?
There are no medicines approved specifically for the treatment of CMD. Relieving pain is one of the main goals of managing CMD. Treatments are also used to control risk factors and other symptoms.
Treatments may include medicines such as:
- Cholesterol medication to improve cholesterol levels
- Blood pressure medications to lower blood pressure and decrease the heart’s workload
- Medication to help prevent blood clots or control inflammation
- Nitroglycerin to relax blood vessels, improve blood flow to the heart muscle, and treat chest pain
The Potential of CLBS16 for the Treatment of CMD
CLBS16 is an experimental regenerative medicine which was studied in a recently completed positive Phase 2a study (the “ESCaPE-CMD trial”) and is currently being studied in a newly initiated Phase 2b study (known as the “FREEDOM trial”) taking place in the U.S. for the treatment of CMD. CLBS16 cell therapy is made from a patient’s own blood cells (meaning it is “autologous”), specifically, special blood vessel forming cells called CD34+ cells. CLBS16 is intended for people who experience chronic chest pain (angina) due to impaired blood flow to the heart (despite not having “clogged” or blocked arteries). Previous research discovered that CD34+ cells play an important part in the body’s natural healing process and have the ability to promote the development and formation of new microvasculature, thereby leading to increased flow of oxygen-rich blood flow to areas of the heart that lack enough oxygen.
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