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Pathophysiology and Diagnosis of Coronary Functional Abnormalities

Jun Takahashi1, Akira Suda1, Kensuke Nishimiya1

  • 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.

European Cardiology
|October 4, 2021
PubMed

Insights

Ischaemia with non-obstructive coronary arteries (INOCA) affects many patients. This review covers advances in understanding the causes and diagnosis of coronary artery spasm and microvascular dysfunction in INOCA.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Many patients undergoing coronary angiography for angina show no obstructive coronary artery disease.
  • This condition is termed ischaemia with non-obstructive coronary arteries (INOCA).
  • Coronary functional abnormalities, including epicardial spasm and microvascular dysfunction, are key to INOCA pathogenesis.

Purpose of the Study:

  • To review recent advances in understanding the pathophysiology of INOCA.
  • To summarize current diagnostic techniques for epicardial coronary artery spasm and coronary microvascular dysfunction.

Main Methods:

  • Review of recent scientific literature on INOCA.
  • Synthesis of evidence regarding coronary functional abnormalities.
  • Overview of diagnostic modalities for vasomotor function.

Main Results:

  • Coronary functional abnormalities are central to INOCA.
  • Evidence supports the prognostic impact of these abnormalities.
  • Comprehensive diagnostic evaluation of coronary vasomotor function is increasingly available.

Conclusions:

  • INOCA is a significant clinical condition.
  • Advances in understanding pathophysiology and diagnosis are crucial.
  • Further research into coronary artery spasm and microvascular dysfunction is warranted.

Keywords:
Epicardial coronary spasmRho-kinasebiomarkercoronary flow reservecoronary microvascular dysfunctioncoronary vasoreactivity testing

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