Coronary Microvascular Spasm: Clinical Presentation and Diagnosis.

Coronary Microvascular Spasm: Clinical Presentation and Diagnosis.
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DOI:
10.15420/ecr.2022.50
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发表时间:
2023
影响因子:
3
通讯作者:
Shimokawa, Hiroaki
Shimokawa, Hiroaki
中科院分区:
其他
文献类型:
--
作者:
Godo, Shigeo;Takahashi, Jun;Shiroto, Takashi;Yasuda, Satoshi;Shimokawa, Hiroaki

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Maseri教授开创了以冠状动脉血管痉挛和冠状动脉微血管功能障碍(CMD)为代表的冠状动脉血管运动异常的研究和治疗。这些机制即使在没有梗阻性冠状动脉疾病的情况下也能导致心肌缺血,已被认为是非梗阻性冠状动脉疾病(INOCA)缺血性患者的重要病因和治疗靶点,具有重要的临床意义。冠状动脉微血管痉挛是INOCA患者心肌缺血的重要机制之一。建议通过有创冠状动脉功能造影术或介入诊断法对冠状动脉血管运动反应性进行综合评估,以确定心肌缺血的潜在机制,并根据INOCA的内型制定最佳治疗和管理方案。该综述重点介绍了Maseri教授的开创性工作,以及在内皮功能障碍、Rho-Kinase激活和炎症方面对冠状动脉血管痉挛和CMD的当代研究。
Professor Maseri pioneered the research and treatment of coronary vasomotion abnormalities represented by coronary vasospasm and coronary microvascular dysfunction (CMD). These mechanisms can cause myocardial ischaemia even in the absence of obstructive coronary artery disease, and have been appreciated as an important aetiology and therapeutic target with major clinical implications in patients with ischaemia with non-obstructive coronary artery disease (INOCA). Coronary microvascular spasm is one of the key mechanisms responsible for myocardial ischaemia in patients with INOCA. Comprehensive assessment of coronary vasomotor reactivity by invasive functional coronary angiography or interventional diagnostic procedure is recommended to identify the underlying mechanisms of myocardial ischaemia and to tailor the best treatment and management based on the endotype of INOCA. This review highlights the pioneering works of Professor Maseri and contemporary research on coronary vasospasm and CMD with reference to endothelial dysfunction, Rho-kinase activation and inflammation.
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