How important is microcirculation in clinical practice?

Global trend and future landscape of coronary microcirculation: A bibliometric and visualized analysis from 1990 to 2021

Background

Coronary microcirculation has a fundamental role in the regulation of coronary blood flow in response to cardiac requirements, which has aroused wide concerns in basic science and clinical cardiovascular research. We aimed to analyze coronary microcirculation-associated literatures over 30 years and provide insightful information on the evolutionary path, frontier research hotspots, and future developmental trends.

Methods

Publications were retrieved from the Web of Science Core Collection (WoSCC). VOSviewer was used to perform co-occurrence analyses for countries, institutions, authors, and keywords and to generate visualized collaboration maps. CiteSpace was used to visualize the knowledge map derived from reference co-citation analysis, burst references, and keywords detection.

Results

This analysis was performed based on 11,702 publications including 9981 articles and 1721 reviews. The United States and Harvard University ranked at the top among all the countries and institutions. The majority of articles were published in Circulation, and it also was the most co-cited journal. Thematic hotspots and frontiers were focused on coronary microvascular dysfunction, magnetic resonance imaging, fractional flow reserve, STEMI, and heart failure. Additionally, keywords burst and co-occurrence cluster analysis showed that management, microvascular dysfunction, microvascular obstruction, prognostic value, outcomes, and guidelines were current knowledge gaps and future directions.

Conclusions

Coronary microcirculation presented a research hotspot relevant wide spectrum of cardiovascular diseases. Definite diagnostics and prognostics are particularly valued. The protection of cardiovascular events that influence clinical outcomes should be an insightful concern in the future. Multidisciplinary collaborations will provide significant advances for the development of coronary microcirculation.

Microvascular function measurement in mice: From large to small

There is a growing body of interest in cardiac microvascular function because it plays an important role in various cardiac disease conditions. Therefore, efforts have been made to develop non-invasive techniques to measure microvascular function. In this issue of the journal, Guerraty et al developed a micro-SPECT-based approach to assess microvascular function in in vivo mice. They applied two independent approaches to measure microvascular function: (1) myocardial blood flow measurement using 99mTc-sestamibi as a flow tracer and (2) intramyocardial blood volume measurement using 99mTc-red blood cells. Although there are issues to be addressed, they provided an important framework for non-invasive assessment of microvascular function in mice, where a number of disease models are readily available. Thus, their approaches are encouraging for facilitating better understanding of pathophysiology underlying microvascular disease models, and thereby the development of therapeutic options in future.