Effects of mineralocorticoid receptor antagonists on coronary microcirculation: a mini-review.
- 1The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang, China.
Abstract
Mineralocorticoid receptor antagonists (MRAs) serve as a foundational therapies in the management of heart failure, hypertension, and chronic kidney disease. Their primary therapeutic efficacy stems from the competitive antagonism of the mineralocorticoid receptor (MR), which mitigates pathological cascades such as endothelial dysfunction, oxidative stress, chronic inflammation, and perivascular fibrosis. Coronary microvascular dysfunction (CMD)-a pivotal pathological driver across a spectrum of cardiovascular diseases-is defined by impaired vasodilation, heightened microvascular resistance, and diminished coronary flow reserve (CFR). Given that CMD is inextricably linked to dysregulated MR signaling, the restoration of microvascular function represents a key mechanism through which MRAs exert their cardioprotective effects. This review delineates the physiological mechanisms, diagnostic indicators, and generational evolution of MRAs in the context of coronary microcirculation. By synthesizing evidence from animal and clinical studies, this work clarifies the therapeutic utility of MRAs for microvascular protection and provides a comprehensive framework for understanding their pharmacological role in CMD research.
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BibTeX
@article{li2026effects,
title = {{Effects of mineralocorticoid receptor antagonists on coronary microcirculation: a mini-review.}},
author = {Yu Li and Zhenhong Zhang},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1855673},
url = {https://europepmc.org/article/MED/42903399},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of mineralocorticoid receptor antagonists on coronary microcirculation: a mini-review.
AU - Yu Li
AU - Zhenhong Zhang
PY - 2026
DA - 2026/10/06
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1855673
UR - https://europepmc.org/article/MED/42903399
AB - Mineralocorticoid receptor antagonists (MRAs) serve as a foundational therapies in the management of heart failure, hypertension, and chronic kidney disease. Their primary therapeutic efficacy stems from the competitive antagonism of the mineralocorticoid receptor (MR), which mitigates pathological cascades such as endothelial dysfunction, oxidative stress, chronic inflammation, and perivascular fibrosis. Coronary microvascular dysfunction (CMD)-a pivotal pathological driver across a spectrum of cardiovascular diseases-is defined by impaired vasodilation, heightened microvascular resistance, and diminished coronary flow reserve (CFR). Given that CMD is inextricably linked to dysregulated MR signaling, the restoration of microvascular function represents a key mechanism through which MRAs exert their cardioprotective effects. This review delineates the physiological mechanisms, diagnostic indicators, and generational evolution of MRAs in the context of coronary microcirculation. By synthesizing evidence from animal and clinical studies, this work clarifies the therapeutic utility of MRAs for microvascular protection and provides a comprehensive framework for understanding their pharmacological role in CMD research.
SN - 2297-055X
ER -