Chest pain with non-obstructive coronary artery disease (NOCAD) occurs more frequently in women than in men and is mainly related to coronary microvascular disease (CMD). The majority of CMD patients are postmenopausal women, suggesting a role for lack of estrogens in the development and progression of CMD. Patients are often discharged without a clear treatment plan due to the limited understanding of etiology and diagnostic parameters of CMD and have significantly higher rates of future cardiovascular events. Thus, there is a need for a better understanding of the underlying biology, and CMD-specific diagnostic tests and therapies. In this article, we reviewed recent studies on CMD, estrogen action in coronary microvasculature, and diagnosis and treatment options for CMD in postmenopausal women.

中文翻译：

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冠状动脉微血管功能障碍和雌激素受体信号传导

非阻塞性冠状动脉疾病 (NOCAD) 引起的胸痛在女性中的发生率高于男性，主要与冠状动脉微血管疾病 (CMD) 相关。大多数 CMD 患者是绝经后妇女，这表明缺乏雌激素在 CMD 的发展和进展中起作用。由于对 CMD 的病因和诊断参数的了解有限，患者经常在没有明确治疗计划的情况下出院，并且未来发生心血管事件的发生率明显更高。因此，需要更好地了解潜在的生物学以及 CMD 特定的诊断测试和疗法。在本文中，我们回顾了最近关于 CMD 的研究、冠状动脉微血管系统中的雌激素作用以及绝经后妇女 CMD 的诊断和治疗选择。