Novel Diagnostic Approaches and Treatment of Angina and Myocardial Ischemia
A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".
Deadline for manuscript submissions: 31 December 2025 | Viewed by 129
Special Issue Editors
Interests: percutaneous coronary intervention; interventional cardiology; myocardial infarction; experimental cardiology; cardiac surgery
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
For years, angina and myocardial ischemia were primarily linked with obstructive coronary artery disease. Recent years have revealed evidence that up to 80% of patients experience angina and detectable demand ischemia, despite non-significant coronary artery narrowing. This has led to reconsideration of and focus on the critical role of coronary microcirculation dysfunction (CMD) in the pathophysiology of angina and ischemia with non-obstructive coronary arteries (ANOCA and INOCA). Moreover, despite advances in revascularization and pharmacological treatment, up to 24% of patients with chronic coronary syndrome may suffer from refractory angina.
The recently published 2024 ESC Guidelines for the management of chronic coronary syndromes underline the role of both non-invasive diagnostic approaches for suspected coronary artery disease and appropriate diagnosis of ANOCA and INOCA endotype, upgrading recommendations for invasive testing from class IIb and IIa to class I. Despite the emphasis on coronary microcirculation testing, the strongest evidence available to date comprises small randomized studies and observational reports. Even less data are available for non-invasive diagnostic methods, which include echocardiography, perfusion coronary computed tomography angiography, and cardiac magnetic resonance.
Lifestyle changes and risk factor modification are the cornerstones of chronic coronary syndrome treatment. In patients with CMD, pharmacological approach is either empirical or should be based on a specific endotype after invasive testing. Frequently used drugs include beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and other agents such as ranolazine or trimetazidine, used in monotherapy or combination. Novel invasive therapies for refractory angina include reducer devices for coronary sinus constriction.
The goal of the current issue is to explore epidemiology, novel diagnostic approaches, and particular groups and treatments of angina and myocardial ischemia, including ANOCA and INOCA. Through a collection of original research articles, reviews, and case reports and series, we aim to provide a comprehensive overview of this emerging topic, investigate unmet needs, and uncover future directions in this rapidly evolving field.
Dr. Marcin Kozuch
Guest Editor
Dr. Emil Julian Dąbrowski
Guest Editor Assitant
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Keywords
- ischemia
- angina
- chronic coronary syndromes
- ANOCA
- INOCA
- CMD
- CFR
- microcirculation
- scintigraphy
- CMR
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