Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction
share announcement

Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (1 October 2022) | Viewed by 9542

Special Issue Editor

Prof. Dr. Alfredo R. Galassi

E-Mail Website
Guest Editor
Chair of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
Interests: chronic total occlusion (CTO); coronary microvascular dysfunction; myocardial infarction with non-obstructive coronary arteries (MINOCA); Ischemia with non-obstructive coronary arteries (INOCA); microvascular angina; vasospastic angina
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Coronary microvascular disfunction (CMVD) is an underdiagnosed condition defined by impaired structure and function of microvascular coronary vessels (MCV). CMVD is characterized by capillary rarefaction, inward remodeling of arterioles, impaired vasodilation, and paradoxical vasoconstriction of MCV. Cardiovascular risk factors, cardiomyopathies, inflammation, platelet activation, and autonomic dysfunction may act in coordination to determine CMVD, but not all of them need to be present. For example, patients with CMVD could present with myocardial infarction without coronary artery disease (MINOCA) or with myocardial ischemia without coronary artery disease (INOCA). These conditions are respectively characterized by patients presenting with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) in whom coronary angiography shows normal (< 30%) or near normal (30-50%) coronary arteries. Intravascular imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT), and cardiac magnetic resonance (CMR) should be used for the differential diagnosis with other possible aetiologies of MINOCA and INOCA. Diagnosis of CMVD could be done via both non-invasive and invasive evaluation of coronary flow reserve (CFR) and through invasive provocative tests for the diagnosis of microvascular vasospasm. CMVD is associated with an increased risk of major adverse cardiac events. Lifestyle changes, risk factor management, anti-ischemic drugs, and aggressive therapy with statins and ace inhibitors are the cornerstone of therapy for CMVD.

Prof. Dr. Alfredo R. Galassi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary microvascular dysfunction
  • myocardial infarction with non-obstructive coronary arteries (MINOCA)
  • lschemia with non-obstructive coronary arteries (INOCA)
  • chronic total occlusion (CTO)
  • microvascular angina
  • vasospastic angina
  • ischemic heart disease
  • biomarkers
  • intravascular imaging

Published Papers (4 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Editorial

Jump to: Research, Review

4 pages, 693 KiB  
Editorial
Classification, Diagnosis, and Treatment of Coronary Microvascular Dysfunction
by Vincenzo Sucato, Cristina Madaudo and Alfredo Ruggero Galassi
J. Clin. Med. 2022, 11(15), 4610; https://doi.org/10.3390/jcm11154610 - 08 Aug 2022
Cited by 5 | Viewed by 3276
Abstract
Coronary microvascular dysfunction represents a widespread disease which is highly disabling for the patient, who constantly presents angina [...] Full article
(This article belongs to the Special Issue Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction)
►▼ Show Figures

Figure 1

Research

Jump to: Editorial, Review

9 pages, 519 KiB  
Article
Longitudinal Strain Analysis and Correlation with TIMI Frame Count in Patients with Ischemia with No Obstructive Coronary Artery (INOCA) and Microvascular Angina (MVA)
by Vincenzo Sucato, Giuseppina Novo, Cristina Madaudo, Luca Di Fazio, Giuseppe Vadalà, Nicola Caronna, Alessandro D’Agostino, Salvatore Evola, Antonino Tuttolomondo and Alfredo Ruggero Galassi
J. Clin. Med. 2023, 12(3), 819; https://doi.org/10.3390/jcm12030819 - 19 Jan 2023
Cited by 2 | Viewed by 1488
Abstract
Background: The aim of the study is to evaluate the subclinical alterations of cardiac mechanics detected using speckle-tracking echocardiography and compare these data with the coronary angiography indices used during coronary angiography in a population of patients diagnosed with ischemia with no obstructive [...] Read more.
Background: The aim of the study is to evaluate the subclinical alterations of cardiac mechanics detected using speckle-tracking echocardiography and compare these data with the coronary angiography indices used during coronary angiography in a population of patients diagnosed with ischemia with no obstructive coronary artery (INOCA) and microvascular angina (MVA). Methods: The study included 85 patients admitted to our center between November 2019 and January 2022 who were diagnosed with INOCA compared with a control group of 70 healthy patients. A collection of anamnestic data and a complete cardiovascular physical examination, and echocardiogram at rest with longitudinal strain were performed for all patients. Furthermore, the TIMI frame count (TFC) for the three coronary vessels was calculated according to Gibson’s indications. All parameters were compared with a control population with similar characteristics. Results: Patients with INOCA compared to the control population showed statistically significant changes in the parameters assessed on the longitudinal strain analysis. In particular, patients with INOCA showed statistically significant changes in GLS (−16.71) compared to the control population (−19.64) (p = 0.003). In patients with INOCA, the total TIMI frame count (tTFC) correlated with the GLS value with a correlation coefficient of 0.418 (p = 0.021). Conclusions: In patients with angina, documented myocardial ischemia, the absence of angiographically significant stenosis (INOCA) and LVEF > 50%, the prevalence of microvascular dysfunction documented by TFC was extremely represented. A statistically significant reduction in GLS was observed in these patients. TFC and longitudinal strain, therefore, appear to be two reliable, sensitive and easily accessible methods for the study of alterations in coronary microcirculation and the characterization of patients with INOCA and microvascular angina. Full article
(This article belongs to the Special Issue Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction)
►▼ Show Figures

Figure 1

11 pages, 877 KiB  
Article
The Index of Microcirculatory Resistance after Primary Percutaneous Coronary Intervention Predicts Long-Term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction
by Gwang-Seok Yoon, Sung Gyun Ahn, Seong-Ill Woo, Myeong Ho Yoon, Man-Jong Lee, Seong Huan Choi, Ji-Yeon Seo, Sung Woo Kwon, Sang-Don Park and Kyoung-Woo Seo
J. Clin. Med. 2021, 10(20), 4752; https://doi.org/10.3390/jcm10204752 - 16 Oct 2021
Cited by 4 | Viewed by 1808
Abstract
The index of microcirculatory resistance (IMR) is a simple method that can measure microvascular function after primary percutaneous coronary intervention (PCI) in patients with ST-segment Elevation Myocardial Infarction (STEMI). This study is to find out whether IMR predicts clinical long-term outcomes in STEMI [...] Read more.
The index of microcirculatory resistance (IMR) is a simple method that can measure microvascular function after primary percutaneous coronary intervention (PCI) in patients with ST-segment Elevation Myocardial Infarction (STEMI). This study is to find out whether IMR predicts clinical long-term outcomes in STEMI patients. A total of 316 patients with STEMI who underwent primary PCI from 2005 to 2015 were enrolled. The IMR was measured using pressure sensor/thermistor-tipped guidewire after primary PCI. The primary endpoint was the rate of death or hospitalization for heart failure (HF) over a mean follow-up period of 65 months. The mean corrected IMR was 29.4 ± 20.0. Patients with an IMR > 29 had a higher rate of the primary endpoint compared to patients with an IMR ≤ 29 (10.3% vs. 2.1%, p = 0.001). During the follow-up period, 13 patients (4.1%) died and 6 patients (1.9%) were hospitalized for HF. An IMR > 29 was associated with an increased risk of death or hospitalization for HF (OR 5.378, p = 0.004). On multivariable analysis, IMR > 29 (OR 3.962, p = 0.022) remained an independent predictor of death or hospitalization for HF with age (OR 1.048, p = 0.049) and symptom-to-balloon time (OR 1.002, p = 0.049). High IMR was an independent predictor for poor long-term clinical outcomes in STEMI patients after primary PCI. Full article
(This article belongs to the Special Issue Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction)
►▼ Show Figures

Figure 1

Review

Jump to: Editorial, Research

14 pages, 1095 KiB  
Review
Pathophysiology, Diagnosis and Treatment of Spontaneous Coronary Artery Dissection in Peripartum Women
by Marta Cano-Castellote, Diego Fernando Afanador-Restrepo, Jhonatan González-Santamaría, Carlos Rodríguez-López, Yolanda Castellote-Caballero, Fidel Hita-Contreras, María del Carmen Carcelén-Fraile and Agustín Aibar-Almazán
J. Clin. Med. 2022, 11(22), 6657; https://doi.org/10.3390/jcm11226657 - 10 Nov 2022
Cited by 3 | Viewed by 2118
Abstract
Spontaneous coronary artery dissection (SCAD) is an infrequent cause of nonobstructive ischemic heart disease in previously healthy young women and therefore is not usually considered in differential diagnoses. The overall incidence of SCAD in angiographic series is between 0.28 and 1.1%, with a [...] Read more.
Spontaneous coronary artery dissection (SCAD) is an infrequent cause of nonobstructive ischemic heart disease in previously healthy young women and therefore is not usually considered in differential diagnoses. The overall incidence of SCAD in angiographic series is between 0.28 and 1.1%, with a clear predominance in young, healthy women (70%) of whom approximately 30% are in the postpartum period. In the United Kingdom, between 2008 and 2012, SCAD was the cause of 27% of acute myocardial infarctions during pregnancy, with a prevalence of 1.81 per 100,000 pregnancies. Regarding the mechanism of arterial obstruction, this may be due to the appearance of an intramural hematoma or to a tear in the intima of the arteries, both spontaneously. Although multiple diagnostic methods are available, it is suggested to include an appropriate anamnesis, an electrocardiogram in the first 10 min after admission to the service or the onset of symptoms, and subsequently, a CT angiography of the coronary arteries or urgent coronary angiography if the hemodynamic status of the patient allows it. Treatment should be individualized for each case; however, the appropriate approach is generally based on two fundamental pillars: conservative medical treatment with antiplatelet agents, beta-blockers, and nitrates, and invasive treatment with percutaneous coronary intervention for stent implantation or balloon angioplasty, if necessary. Full article
(This article belongs to the Special Issue Classification, Diagnosis and Treatment of Coronary Microvascular Dysfunction)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-4
Back to TopTop