Myocardial Ischemia: Differentiating between Epicardial Coronary Artery Atherosclerosis, Microvascular Dysfunction and Vasospasm in the Catheterization Laboratory.
Giovanni MonizziFrancesca Di LenardaEmanuele GallinoroAntonio Luca BartorelliPublished in: Journal of clinical medicine (2024)
Ischemic heart disease is currently the most common cause of mortality and morbidity worldwide. Although myocardial ischemia is classically determined by epicardial coronary atherosclerosis, up to 40% of patients referred for coronary angiography have no obstructive coronary artery disease (CAD). Ischemia with non-obstructive coronary artery disease (INOCA) has typically been underestimated in the past because, until recently, its prognostic significance was not completely clear. This review aims to highlight differences and patterns in myocardial ischemia caused by epicardial obstructive CAD, coronary microvascular dysfunction (CMD) or vasomotor abnormalities and to elucidate the state of the art in correctly diagnosing these different patterns.
Keyphrases
- coronary artery disease
- cardiovascular events
- coronary artery
- percutaneous coronary intervention
- coronary artery bypass grafting
- left ventricular
- end stage renal disease
- oxidative stress
- cardiovascular disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- pulmonary artery
- subarachnoid hemorrhage
- prognostic factors
- peritoneal dialysis
- aortic stenosis
- heart failure
- patient reported outcomes
- transcatheter aortic valve replacement
- ultrasound guided
- cerebral ischemia