Emerging Biomarkers of Coronary Microvascular Dysfunction: From Discovery to Clinical Translation

Coronary microvascular dysfunction (CMD) represents a growing frontier in cardiovascular medicine, characterized by impaired regulation of myocardial blood flow at the microvascular level. Despite its prevalence and significant impact on patient outcomes including angina, ischemia without obstructive coronary arteries, and heart failure with preserved ejection fraction CMD often eludes detection due to limitations in current diagnostic approaches. Emerging evidence highlights a complex pathophysiology involving endothelial dysfunction, vascular smooth muscle anomalies, inflammatory mechanisms, and microvascular rarefaction. Yet, the field still lacks robust, easily accessible biomarkers that can enhance diagnosis, enable precise risk stratification, and monitor therapeutic response, leaving significant clinical need and research gaps.The goal of this Research Topic is to catalyze progress in the identification, characterization, and validation of novel CMD biomarkers across multiple platforms such as blood-based assays, advanced imaging, physiological testing, and omics technologies. We invite researchers to explore how these emerging markers can illuminate CMD endotypes, reveal underlying mechanisms, and improve the clinical interaction from diagnosis to prognosis. By bridging the gap between laboratory advances and patient care, this collection aims to foster scientific dialogue, harmonize methodologies, and chart a path toward refined, individualized management of CMD.To expand and energize this field, we encourage submissions that push the boundaries of current knowledge and span a wide range of innovative research. Topics of interest include, but are not limited to:• Discovery and clinical validation of circulating biomarkers such as endothelial activation, inflammation, thrombosis, oxidative stress, extracellular vesicles, and multi-marker panels• Application of omics and systems biology approaches such as genomics, transcriptomics, proteomics, metabolomics, and epigenetics for comprehensive CMD profiling• Advances in imaging- and physiology-derived biomarkers, with emphasis on validation and standardization such as PET, CMR, CT myocardial blood flow metrics, coronary flow reserve, and invasive indices• Assessment of biomarker relevance and performance within diverse CMD populations including INOCA, HFpEF, diabetes, obesity, autoimmune conditions, and sex-based differences• Studies on analytical and clinical validation, reproducibility, and clinical implementation thresholds• Exploration of biomarkers as tools for prognosis and therapeutic monitoring, particularly in the context of interventional and pharmacological trialsWe welcome original research articles, methods papers, brief reports, and focused reviews that will shape the future of CMD diagnosis and management. Topic editors: Ali Aldujeli, Nishtha Sareen, Vacis Tatarūnas Source: https://www.frontiersin.org/research-topics/83355/emerging-biomarkers-of-coronary-microvascular-dysfunction-from-discovery-to-clinical-translation