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. 2023 Jan 20;13:1028429. doi: 10.3389/fendo.2022.1028429

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Copyright © 2023 Shan, Shuwen, Hengbin and Min

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The mechanism of INOCA. INOCA is represented by CMD. It can be caused by oxidative stress, adipokines produced by EAT, changes in circulating factor concentrations in plasma, and changes in ESL. CMD is determined by a combination of factors including endothelial dysfunction, vascular smooth muscle cell hyperreactivity, vascular remodeling, vascular fibrosis, and changes in macrophage function (see text for details). A possible adjustment procedure is proposed for this. CMD: coronary microvascular dysfunction.*Green represents several conditions that produce CMD under abnormal EAT; brown represents pathways that promote inflammation; yellow represents pathways that inhibit inflammation. (Created with BioRender.com).