Cardiac magnetic resonance imaging in myocardial infarction with non-obstructive coronary arteries (MINOCA): current and evolving perspectives.

IF 2.5 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI:10.1080/14779072.2025.2577397

Michele Di Leo, Nicolò Vasumini, Angelo Maida, Tommaso Manaresi, Marco Basile, Francesco Angeli, Matteo Armillotta, Marcello Casuso Alvarez, Leonardo Luca Bavuso, Rebecca Belà, Jessica Salerno, Damiano Fedele, Lisa Canton, Sara Amicone, Roberto Carletti, Elisa Gardini, Luca Bergamaschi, Carmine Pizzi

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引用次数: 0

Abstract

Introduction: Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) represents a diagnostic challenge, requiring the exclusion of non-ischemic causes such as myocarditis, Takotsubo syndrome, and cardiomyopathies. Cardiac magnetic resonance (CMR) plays a pivotal role in differentiating MINOCA from these conditions by providing detailed tissue characterization to identify inflammation, edema, and fibrosis. This review explores the expanding role of CMR in diagnosing, reclassifying, and managing MINOCA, emphasizing its ability to guide treatment, improve prognosis, and aid risk stratification by identifying underlying causes.

Areas covered: This narrative review discusses recent advancements in CMR protocols for suspected MINOCA, its role in distinguishing ischemic from non-ischemic causes of acute myocardial injury, and its emerging utility in risk stratification and personalized therapy. Relevant articles were searched in PubMed, Scopus, and Cochrane databases up to February 2025.

Expert opinion: CMR is the noninvasive gold standard for diagnosing MINOCA. Its emerging role in evaluating coronary microcirculation, along with integrated approaches using coronary computed tomography, will further enhance the noninvasive assessment of MINOCA, in particular determining potential coronary and non-coronary etiologies.

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非阻塞性冠状动脉心肌梗死（MINOCA）的心脏磁共振成像：当前和未来的观点。

非阻塞性冠状动脉心肌梗死（MINOCA）是一种诊断挑战，需要排除非缺血性原因，如心肌炎、Takotsubo综合征和心肌病。心脏磁共振（CMR）通过提供详细的组织特征来识别炎症、水肿和纤维化，在将MINOCA与这些疾病区分开来方面起着关键作用。本文探讨了CMR在MINOCA的诊断、重新分类和管理中不断扩大的作用，强调了其指导治疗、改善预后的能力，并通过识别潜在原因帮助进行风险分层。涵盖领域：本综述讨论了疑似MINOCA的CMR方案的最新进展，其在区分缺血性和非缺血性原因的急性心肌损伤中的作用，以及其在风险分层和个性化治疗中的新应用。相关文章在PubMed， Scopus和Cochrane数据库中检索到2025年2月。专家意见：CMR是诊断MINOCA的无创金标准。它在评估冠状动脉微循环方面的新作用，以及冠状动脉计算机断层扫描的综合方法，将进一步加强MINOCA的无创评估，特别是确定潜在的冠状动脉和非冠状动脉病因。

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

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.