Role of Intracoronary Imaging in Myocardial Infarction with Non-Obstructive Coronary Disease (MINOCA): A Review.
Irene BorzilloOvidio De FilippoRossella ManaiFrancesco BrunoEmanuele RavettiAlma Andrea GalantiRocco VergalloItalo PortoGaetano Maria De FerrariFabrizio D'AscenzoPublished in: Journal of clinical medicine (2023)
Myocardial infarction with non-obstructive coronary artery disease occurs in 6% to 15% of all presentation of myocardial infarctions. The pathophysiologic mechanisms of MINOCA include epicardial vasospasm, coronary microvascular disorder, spontaneous coronary artery dissection, and coronary thrombus/embolism. The diagnosis is challenging, supported by intracoronary imaging with intravascular ultrasound (IVUS) and optical coherent tomography (OCT), coronary physiology testing, and cardiac magnetic resonance imaging (CMR). OCT is able to identify atherosclerotic causes of MINOCA (plaque erosion, plaque rupture, and calcified nodule) and nonatherosclerotic causes (spontaneous artery dissection, and spasm). In this review, we summarize the performance of the two intracoronary imaging modalities (IVUS and OCT) in MINOCA and discuss the importance of supplementing these modalities with CMR in order to drive target therapy.
Keyphrases
- coronary artery disease
- coronary artery
- high resolution
- magnetic resonance imaging
- pulmonary artery
- left ventricular
- percutaneous coronary intervention
- coronary artery bypass grafting
- cardiovascular events
- optical coherence tomography
- heart failure
- st elevation myocardial infarction
- diabetic retinopathy
- stem cells
- aortic stenosis
- computed tomography
- mass spectrometry
- acute coronary syndrome
- subarachnoid hemorrhage
- case report
- cardiovascular disease
- bone marrow
- replacement therapy
- high speed
- brain injury
- optic nerve