The underlying pathophysiological mechanism linking pre-eclampsia with the subsequent development of coronary microcirculation dysfunction is intrinsic to the endothelial dysfunction mechanisms that underpin the development of pre-eclampsia itself: endothelial dysfunction [8,29], angiogenic imbalance [30], oxidative stress [9], and inflammation, renin-angiotensin-aldosterone system dysregulation [10], impaired calcium handling [19]. This evidence concerns the gene REN and endothelial dysfunction.