الفهرس 
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Abstract
Summary
Background:
The increasing use of invasive and non-invasive coronary and peripheral microvascular assessment methods has unravelled the role of microvascular dysfunction in several CV disease manifestations. In parallel, a better understanding of the biological mechanisms involved in microvascular dysfunction has shown that regulation of the microvascular phenotype is highly dynamic and tightly regulated by elevated levels of systemic inflammation.
The refinement of microvascular assessment techniques provide now a unique opportunity to move microvascular research, potentially allowing the earlier identification of patients at high CV risk. Furthermore, the adoption of a more integrated approach to microvascular research in the future, whereby central and peripheral microvascular assessments are performed, has the potential to accelerate the identification of novel and disease-specific therapeutic targets and the development of drugs that could be used to prevent the evolution and clinical consequences of microvascular disease.
Aim of the work:
The aim of this study is to determine different parameters leading to micro-vascular dysfunction as good screening tests.
Patients and Methods:
This study was conducted in Beni-Suefuniversity Hospital in the period from October 2020 to June 2022. The study included 152 patients with suspected coronary artery disease upon associated risk factors were divided as 76 patients characterized by the presence of angina-like chest pain, a positive response to exercise stress tests, and no significant stenosis of coronary arteries in coronary angiography, with absence of any other specific cardiac disease and 76 patients control group.
Results:
In this study, CRP, HDL, LDL, Cholesterol, and triglyceride was higher significantly in cases than controls.
Also, the mean latency in upper and lower limb higher significantly in cases than controls. Additionally, there a significant higher amplitude of the upper limb in cases than controls. R-R internal variation (RRIV) parameters during rest and during breathing were significantly higher in cases than in controls patients.
Results showed that significant roles of latency in lower limb and resting RRIV in prediction of Coronary Micro-Vascular Dysfunction in Patients without Myocardial Disease and Obstructive Atherosclerosis.
Results detected that the only autonomic function that found to increase the probability of Coronary Micro-Vascular Dysfunction was the latency in lower limb, presence of Diabetes in addition to the increase of LDL.
Conclusion:
In conclusion, the established functional tests of the cardiovascular autonomic nervous system presented here are sufficiently standardized and well-proven. In most cases, they allow for an assessment of the cardiovascular autonomic nervous system by simple means. The routine diagnostics of autonomic functional disorders can offer a more specific diagnostics of micro-vascular dysfunction risk.