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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Invasive Coronary Assessment in Myocardial Ischemia with No Obstructive Coronary Arteries

Tatsunori Takahashi1, Aakriti Gupta1, Bruce A Samuels1

  • 1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Current Atherosclerosis Reports
|September 8, 2023
PubMed

Insights

Invasive coronary function testing accurately assesses ischemia with no obstructive coronary arteries (INOCA), improving diagnosis and guiding therapy. This method enhances risk stratification and quality of life for INOCA patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Testing

Background:

  • Ischemia with no obstructive coronary arteries (INOCA) presents a diagnostic challenge.
  • Accurate assessment is crucial for effective patient management and prognosis.

Purpose of the Study:

  • To review invasive methods for assessing INOCA in cardiac catheterization.
  • To describe prognostic and treatment implications of INOCA findings.
  • To identify knowledge gaps and future research directions in INOCA.

Main Methods:

  • Overview of established invasive diagnostic techniques used in the cardiac catheterization laboratory.
  • Analysis of prognostic data and treatment strategies informed by invasive assessments.
  • Discussion of current literature and clinical guidelines.

Main Results:

  • Invasive coronary function testing aids in risk stratification for INOCA patients.
  • This testing guides medical therapy, leading to symptom improvement and enhanced quality of life.
  • Invasive assessment is recommended by 2021 ACC/AHA guidelines for diagnosing coronary microvascular dysfunction.

Conclusions:

  • Comprehensive invasive assessment is key to differentiating INOCA endotypes.
  • Optimizing medical therapy and preventive strategies, including lifestyle changes, is essential.
  • Invasive functional testing is well-established and readily performed in catheterization labs.
Abstract

Keywords:
Coronary microvascular dysfunctionINOCAInvasive coronary function testingVasospastic angina

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