Role of Intracoronary Imaging in Myocardial Infarction with Non-Obstructive Coronary Disease (MINOCA): A Review

Myocardial infarction with non-obstructive coronary artery disease occurs in 6% to 15% of all presentation of myocardial infarctions. The pathophysiologic mechanisms of MINOCA include epicardial vasospasm, coronary microvascular disorder, spontaneous coronary artery dissection, and coronary thrombus...

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Detalles Bibliográficos
Autores principales: Borzillo, Irene, De Filippo, Ovidio, Manai, Rossella, Bruno, Francesco, Ravetti, Emanuele, Galanti, Alma Andrea, Vergallo, Rocco, Porto, Italo, De Ferrari, Gaetano Maria, D’Ascenzo, Fabrizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051698/
https://www.ncbi.nlm.nih.gov/pubmed/36983131
http://dx.doi.org/10.3390/jcm12062129
Descripción
Sumario:Myocardial infarction with non-obstructive coronary artery disease occurs in 6% to 15% of all presentation of myocardial infarctions. The pathophysiologic mechanisms of MINOCA include epicardial vasospasm, coronary microvascular disorder, spontaneous coronary artery dissection, and coronary thrombus/embolism. The diagnosis is challenging, supported by intracoronary imaging with intravascular ultrasound (IVUS) and optical coherent tomography (OCT), coronary physiology testing, and cardiac magnetic resonance imaging (CMR). OCT is able to identify atherosclerotic causes of MINOCA (plaque erosion, plaque rupture, and calcified nodule) and nonatherosclerotic causes (spontaneous artery dissection, and spasm). In this review, we summarize the performance of the two intracoronary imaging modalities (IVUS and OCT) in MINOCA and discuss the importance of supplementing these modalities with CMR in order to drive target therapy.

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