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MINOCA and INOCA: Role in Heart Failure

Ana G Almeida1

  • 1Cardiology, Heart and Vessels Department, University Hospital Santa Maria, Faculty of Medicine of Lisbon University, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal. anagalmeida@gmail.com.

Current Heart Failure Reports
|May 17, 2023
PubMed

Insights

Myocardial infarction (MINOCA) and ischemia (INOCA) with non-obstructive coronary disease are linked to heart failure (HF). Further research is needed for risk factors, diagnosis, and prevention strategies for MINOCA and INOCA related HF.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Heart Failure Research

Background:

  • Myocardial infarction (MINOCA) and ischemia (INOCA) with non-obstructive coronary disease are emerging presentations of coronary syndromes.
  • These conditions are increasingly recognized due to advancements in cardiovascular imaging.
  • Both MINOCA and INOCA are associated with heart failure (HF).

Purpose of the Study:

  • To review the relationship between MINOCA, INOCA, and heart failure.
  • To highlight the impact of microvascular dysfunction in INOCA and HFpEF.
  • To identify gaps in understanding and management of HF in MINOCA and INOCA.

Main Methods:

  • Review of recent clinical literature and imaging techniques.
  • Analysis of the association between MINOCA/INOCA and heart failure.
  • Examination of underlying mechanisms including left ventricular dysfunction and endothelial dysfunction.

Main Results:

  • MINOCA is associated with significant adverse outcomes, including prevalent heart failure events.
  • INOCA, particularly involving microvascular dysfunction, is linked to heart failure with preserved ejection fraction (HFpEF).
  • HF is a common complication in both MINOCA and INOCA.

Conclusions:

  • MINOCA and INOCA are significantly related to heart failure, necessitating further investigation.
  • Established secondary prevention strategies for HF in MINOCA are lacking.
  • Coronary microvascular dysfunction in INOCA contributes to diastolic dysfunction and HFpEF.
Abstract

Keywords:
Heart failureINOCAMINOCANon-obstructive coronary diseasePrognosis

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