Table 1.

Research Questions and Clinical Implications

Research questions
Do patients with documented CMD and endothelial dysfunction, seen with other diseases, benefit from aspirin, statins, or treatments that have an effect on the endothelium?
What is the role of female hormones in endothelial dysfunction? How can the sex differences in these diseases be explained?
Are there clinical, genetic, or epigenetic factors that trigger endothelial dysfunction in various microvascular beds?
Further research is needed to understand the exact mechanisms involved in the development and course of diabetic cardiomyopathy to facilitate the discovery of clinically effective targets for preventing this condition and its progression to heart failure.
What is the association of breast arterial calcification with endothelial dysfunction? Can it be used as a marker of CMD?

Clinical implications
Does the shared common pathway of endothelial dysfunction account for the increase in adverse cardiovascular events in these diseases?
Should patients with other diseases that involve endothelial dysfunction be referred to cardiovascular specialists?
What treatments and lifestyle changes can decrease the symptoms and adverse clinical outcomes of patients with endothelial dysfunction?

CMD, coronary microvascular dysfunction.