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Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction

Paolo Severino1, Andrea D'Amato1, Silvia Prosperi1

  • 1Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy.

Journal of Clinical Medicine
|May 27, 2023
PubMed

Insights

Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is a common cause of death. Coronary microvascular dysfunction (CMD) is a key factor, and understanding its genetic basis is crucial for future treatments.

Area of Science:

  • Cardiology
  • Genetics
  • Pathophysiology

Background:

  • Ischemic heart disease (IHD) is a leading global cause of mortality.
  • Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is an increasingly recognized clinical entity.
  • MINOCA encompasses diverse mechanisms, including atherosclerotic and non-atherosclerotic causes.

Purpose of the Study:

  • To review the pathophysiology of MINOCA.
  • To focus on coronary microvascular dysfunction (CMD) as a key mechanism in MINOCA.
  • To explore the current understanding of genetic predisposition to CMD.

Main Methods:

  • Literature review of MINOCA pathophysiology.
  • Analysis of CMD mechanisms in MINOCA.
  • Examination of genetic factors implicated in CMD.

Main Results:

  • Coronary microvascular dysfunction (CMD) significantly contributes to MINOCA pathophysiology and prognosis.
  • Genetic susceptibility is hypothesized to play a role in the development of CMD.
  • Current knowledge on the genetic mechanisms underlying CMD is limited.

Conclusions:

  • Further research is essential to elucidate the genetic basis of CMD.
  • Understanding genetic variants in microcirculation dysfunction can lead to early risk identification.
  • Tailored pharmacological strategies for MINOCA patients can be developed through genetic insights.

Keywords:
INOCAMINOCAcoronary flow reservecoronary microvascular dysfunctiongenetic predispositionindex of microvascular resistance

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