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Related Concept Videos

Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Is an ischemic origin in MINOCA patients predictable?

Alban Lamour1,2, Audrey Camarzana1,2, Christoph Gräni3

  • 1Institut Mitovasc, UMR CNRS 6015-INSERMU1083, University of Angers, 49000, Angers, France.

The International Journal of Cardiovascular Imaging
|July 27, 2020
PubMed
Summary
This summary is machine-generated.

Identifying myocardial infarction in patients with non-obstructive coronary arteries (MINOCA) is crucial. Absence of inflammation, high troponin, and coronary atheroma strongly indicate an ischemic origin in MINOCA cases.

Keywords:
CMRMINOCAMyocarditis

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Biomarkers

Background:

  • Myocardial infarction with non-obstructive coronary arteries (MINOCA) presents diagnostic challenges due to its multifaceted pathophysiology.
  • Accurate identification of ischemic origin is vital for appropriate patient management.

Purpose of the Study:

  • To identify key parameters that can reliably indicate an ischemic origin in patients diagnosed with MINOCA.
  • To improve the diagnostic accuracy for myocardial infarction in the MINOCA population.

Main Methods:

  • Retrospective analysis of 135 MINOCA patients who underwent cardiovascular magnetic resonance imaging (CMR).
  • Classification of patients into diagnostic groups: myocarditis, myocardial infarction, Takotsubo cardiomyopathy, or normal/uncommon findings based on CMR.
  • Multivariate analysis to identify independent predictors of myocardial infarction.

Main Results:

  • Cardiovascular magnetic resonance imaging (CMR) revealed myocarditis in 62%, myocardial infarction in 14.1%, Takotsubo cardiomyopathy in 4.4%, and other diagnoses in 19.3% of MINOCA patients.
  • Absence of inflammatory response, presence of coronary atheroma on angiography, and elevated peak troponin (>150) were independently correlated with myocardial infarction.
  • The presence of all three criteria predicted myocardial infarction in 71.4% of cases, with a negative predictive value of 96% for MI when at least two criteria were met.

Conclusions:

  • Absence of inflammatory response, presence of coronary atheroma, and elevated troponin levels are significant indicators of myocardial infarction as the cause of MINOCA.
  • These criteria can aid clinicians in identifying an ischemic origin in MINOCA patients, improving diagnostic precision.