Coronary Microvascular Spasm: Clinical Presentation and Diagnosis

Area of Science:

• Cardiology
• Vascular Biology
• Internal Medicine

Background:

• Professor Maseri's research advanced understanding of coronary vasomotion abnormalities, including coronary vasospasm and coronary microvascular dysfunction (CMD).
• These conditions cause myocardial ischemia even without obstructive coronary artery disease, impacting patients with ischemia with non-obstructive coronary artery disease (INOCA).
• Coronary microvascular spasm is a primary cause of myocardial ischemia in INOCA patients.

Purpose of the Study:

• To review Professor Maseri's pioneering work and current research on coronary vasospasm and CMD.
• To highlight the clinical implications and therapeutic targets for INOCA.
• To discuss the roles of endothelial dysfunction, Rho-kinase activation, and inflammation in these conditions.

Main Methods:

• Review of seminal and contemporary research on coronary vasomotion.
• Discussion of invasive functional coronary angiography and interventional diagnostic procedures.
• Analysis of mechanisms including endothelial dysfunction, Rho-kinase activation, and inflammation.

Main Results:

• Coronary vasospasm and CMD are significant causes of myocardial ischemia in INOCA.
• Comprehensive assessment of coronary vasomotor reactivity is crucial for diagnosis and tailored treatment.
• Endothelial dysfunction, Rho-kinase activation, and inflammation are key pathophysiological factors.

Conclusions:

• Coronary vasospasm and CMD are vital considerations in patients with INOCA.
• Personalized treatment strategies based on endotype are essential for managing myocardial ischemia.
• Further research into underlying mechanisms will refine therapeutic approaches.