Definitions and Epidemiology of Coronary Functional Abnormalities

Area of Science:

• Cardiology
• Vascular Medicine
• Physiology

Background:

• Coronary functional abnormalities are common causes of angina pectoris, especially in patients with unobstructed coronary arteries.
• These abnormalities encompass a spectrum of pathologies, including enhanced vasoconstriction (coronary artery spasm) and impaired vasodilation (reduced coronary flow reserve, increased microvascular resistance).
• Vasomotor dysfunction can impact both epicardial arteries and the coronary microcirculation.

Purpose of the Study:

• To define coronary functional abnormalities and their endotypes with current cut-off values.
• To describe diagnostic methods for identifying and differentiating these endotypes.
• To summarize contemporary data on the prevalence and coexistence of various coronary functional abnormality endotypes.

Main Methods:

• Literature review and synthesis of existing data.
• Description of established diagnostic criteria and methodologies.
• Analysis of prevalence data from clinical studies.

Main Results:

• Detailed definitions and accepted cut-off values for different coronary functional abnormalities are presented.
• Diagnostic approaches for distinguishing between endotypes (e.g., spasm, microvascular dysfunction) are outlined.
• Current prevalence estimates for various endotypes and their co-occurrence are summarized.

Conclusions:

• Clear categorization and nomenclature of coronary functional abnormalities are essential for clinical practice and research.
• Accurate diagnosis and understanding of endotype prevalence improve patient management and trial design.
• This review provides a framework for consistent evaluation and reporting of these conditions.