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Reduction in stroke volume, systolic and mean arterial pressure, which may cause reduced coronary perfusion pressure
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Decreased density of coronary microvasculature
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Attenuated and delayed systolic forward compression wave of coronary blood flow
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Increased resting diastolic backward expansion wave
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Reduction in resting microvascular resistance, with inability to reduce further in response to hyperaemia
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Upregulation of vasoactive factors, leading to increased resting blood flow
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Microvascular dysfunction impairing hyperaemic response
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Reversal of normal endocardial-epicardial blood flow ratio at rest
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Reduced diastolic coronary perfusion phase
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Attenuated coronary flow reserve
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