Challenges in diagnosing coronary microvascular dysfunction and coronary vasospasm.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine Pub Date : 2025-04-17 DOI:10.1016/j.carrev.2025.04.025

Sonya Burgess, F Aaysha Cader, Martha Gulati, Nadia R Sutton, Yolande Appelman, Shrilla Banerjee

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引用次数: 0

Abstract

Chronic coronary syndromes (CCS) include 2 overlapping subgroups of patients - those with angina with nonobstructive coronary arteries (ANOCA), or ischaemia with non-obstructive coronary arteries (INOCA). A diagnosis of ANOCA-INOCA, is common and should be considered where angina is present and/or ischaemia is found on functional imaging in the absence of obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CCTA) or invasive coronary angiography (ICA) (Ford and Berry, 2019). This review aims to provide an overview of contemporary challenges in the diagnosis of coronary microvascular dysfunction (CMD) and vasospastic disease, with a focus on recent guideline changes and current controversies. CMD and vasospastic angina (VSA) are increasingly acknowledged as an important and frequently overlooked, under investigated, and undertreated entities that contribute to ANOCA-INOCA (Samuels et al., 2023; Kunadian et al., 2020; Ford and Berry, 2019; Burgess and Mamas, 2024).

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诊断冠状动脉微血管功能障碍和冠状血管痉挛的挑战。

慢性冠状动脉综合征（CCS）包括2个重叠的患者亚组-心绞痛合并非阻塞性冠状动脉（ANOCA）或缺血性合并非阻塞性冠状动脉（INOCA）。在冠状动脉计算机断层血管造影（CCTA）或侵入性冠状动脉造影（ICA）未发现阻塞性冠状动脉疾病（CAD）的情况下，如果在功能成像上发现心绞痛和/或缺血，则应考虑ANOCA-INOCA的诊断（Ford and Berry, 2019）。本文旨在概述当前冠状动脉微血管功能障碍（CMD）和血管痉挛疾病的诊断挑战，重点介绍最近的指南变化和当前的争议。CMD和血管痉挛性心绞痛（VSA）越来越被认为是导致ANOCA-INOCA的重要但经常被忽视、调查不足和治疗不足的实体(Samuels等，2023；Kunadian et al., 2020；Ford and Berry, 2019；伯吉斯和妈妈，2024)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.90%

发文量

687

审稿时长

36 days

期刊介绍： Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.