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Life
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Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications
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Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 2463

Special Issue Editors

Dr. Michele Russo

E-Mail Website
Guest Editor
Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, 31015 Conegliano, Italy
Interests: coronary artery disease; acute coronary syndromes; coronary atherosclerosis; optical coherence tomography; coronary plaque instability, coronary vasomotor disorders
Dr. Filippo Luca Gurgoglione

E-Mail Website
Guest Editor
Department of Cardiology, Parma University Hospital, 43126 Parma, Italy
Interests: ischemic heart disease; acute coronary syndromes; coronary atherosclerosis; coronary vasomotor disorders; coronary microvascular dysfunction; interventional cardiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Coronary artery disease (CAD) represents the main determinant of ischemic heart disease (IHD); the latter is estimated to be the principal cause of disability and death worldwide, and it is expected to maintain this leading role in determining health loss until 2050. Coronary atherosclerosis (CA) is the main pathophysiological mechanism of CAD. Atherosclerotic coronary plaque formation, progression, destabilization, and healing are evolutive and dynamic processes that are able to determine different clinical manifestations of CAD, from stable angina to acute coronary syndromes and sudden coronary death. In recent years, cardiovascular research has increasingly focused on understanding the mechanisms of coronary pathophysiology and the role of traditional and emerging risk factors in outlining the course of CA, with the main aims of preventing atherosclerosis development and avoiding potential clinical consequences of abrupt plaque progression. The advent and implementation of new coronary imaging modalities (noninvasive and invasive) have given a strong boost to this research, consenting to study in vivo coronary plaque evolution in larger study cohorts, and concurring to explore new determinants in enhancing the atherosclerotic cascade. A deeper knowledge of potential factors able to modulate atherosclerotic processes may be of remarkable relevance for new therapeutic approaches. In this Special Issue, we aim to examine new evidence of CAD, focusing on pathophysiological mechanisms, conventional and new risk factors and CA-associated diseases, invasive and noninvasive atherosclerotic coronary imaging, and new therapeutic targets.

Dr. Michele Russo
Dr. Filippo Luca Gurgoglione
Guest Editors

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Keywords

  • coronary artery disease
  • coronary atherosclerosis
  • atherosclerotic plaque progression
  • coronary imaging
  • cardiovascular risk factors and coronary atherosclerosis-associated diseases

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Published Papers (3 papers)

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Research

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22 pages, 1027 KiB  
Article
Mental Illness Strikes at the Heart: Impact of Psychiatric Diseases on Ventricular Ejection Fraction in Patients with Acute Coronary Syndromes
by Marianna Mazza, Giorgio Veneziani, Francesco Maria Lisci, Sofia Morini, Gianandrea Traversi, Greta Sfratta, Caterina Brisi, Maria Benedetta Anesini, Francesca Bardi, Elisabetta Benini, Claudia Calderoni, Luca Chisari, Arianna Crupi, Emanuela De Chiara, Luca Lo Giudice, Luca Onori, Ilenia Sessa, Marta Balocchi, Roberto Pola, Eleonora Gaetani, Benedetta Simeoni, Francesco Franceschi, Gabriele Sani, Marcello Covino, Carlo Lai, Enrico Romagnoli and Giuseppe Maranoadd Show full author list remove Hide full author list
Life 2025, 15(3), 340; https://doi.org/10.3390/life15030340 - 21 Feb 2025
Viewed by 672
Abstract
Mental illnesses can have a significant impact on individuals experiencing acute coronary syndromes (ACS). Mental illnesses are associated with an increased cardiovascular risk profile and early onset of cardiovascular disease. A critical aspect of this interplay is the effect of psychiatric conditions on [...] Read more.
Mental illnesses can have a significant impact on individuals experiencing acute coronary syndromes (ACS). Mental illnesses are associated with an increased cardiovascular risk profile and early onset of cardiovascular disease. A critical aspect of this interplay is the effect of psychiatric conditions on left ventricular ejection fraction (LVEF), a key parameter in evaluating cardiac function and predicting long-term outcomes in ACS patients. The present single-center, retrospective study investigated the associations between psychiatric conditions and cardiac function, with a focus on LVEF in ACS patients. The inclusion criteria were Italian nationality and 30 years or older. One hundred and sixty-four patients without (Mage = 68.8 ± 10.6, 62 females) and 161 patients with a psychiatric diagnosis (Mage = 68.4 ± 13.7, 63 females) were enrolled. The data collected included sociodemographic variables, psychiatric diagnoses, LVEF, ACS type (STEMI/NSTEMI), smoking status, previous interventions, and pharmacological treatments. Statistical analyses included chi-square, t-tests, ANOVAs, and ANCOVA to assess differences across groups. Findings revealed lower LVEF in patients with a psychiatric diagnosis compared to patients without a psychiatric diagnosis (p = 0.004, d = 0.36). Patients without a psychiatric diagnosis were associated with NSTEMI (p = 0.047, φ = 0.11), hypertension (p = 0.003, φ = −0.16), and dyslipidemia (p = 0.022, φ = −0.13). In contrast, patients with a psychiatric diagnosis were associated with STEMI (p = 0.047, φ = 0.11), neurological dysfunction (p = 0.014, φ = 0.14), and chronic obstructive pulmonary disease (p = 0.010, φ = 0.14). Among psychiatric diagnoses, anxiety disorders were associated with lower LVEF compared to substance abuse disorders (p = 0.012, d = −0.81). The findings underscore the complex relationship between mental illness and cardiac function, emphasising the need to integrate psychiatric evaluations into cardiology care to optimise the management of both mental and cardiovascular health. This study has several limitations, including its design, which prevents causal conclusions, and the use of convenience sampling, which limits the generalizability of the findings. Full article
(This article belongs to the Special Issue Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications)
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Review

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35 pages, 2271 KiB  
Review
Coronary Artery Spasm: From Physiopathology to Diagnosis
by Ilinca Savulescu-Fiedler, Radu Octavian Baz, Radu Andrei Baz, Cristian Scheau and Andrei Gegiu
Life 2025, 15(4), 597; https://doi.org/10.3390/life15040597 - 3 Apr 2025
Viewed by 734
Abstract
Coronary artery spasm (CAS) is a reversible vasoconstriction of normal or atherosclerotic epicardial coronary arteries with a subsequent reduction in myocardial blood flow, leading to myocardial ischemia, myocardial infarction, severe arrhythmias, or even sudden death. It is an entity that should be recognized [...] Read more.
Coronary artery spasm (CAS) is a reversible vasoconstriction of normal or atherosclerotic epicardial coronary arteries with a subsequent reduction in myocardial blood flow, leading to myocardial ischemia, myocardial infarction, severe arrhythmias, or even sudden death. It is an entity that should be recognized based on a particular clinical presentation. Numerous differences exist between CAS and obstructive coronary disease in terms of mechanisms, risk factors, and therapeutic solutions. The gold standard for CAS diagnosis is represented by transitory and reversible occlusion of the coronary arteries at spasm provocation test, which consists of an intracoronary administration of Ach, ergonovine, or methylergonovine during angiography. The pathophysiology of CAS is not fully understood. However, the core of CAS is represented by vascular smooth muscle cell contraction, with a circadian pattern. The initiating event of this contraction may be represented by endothelial dysfunction, inflammation, or autonomic nervous system unbalance. Our study explores the intricate balance of these factors and their clinical relevance in the management of CAS. Full article
(This article belongs to the Special Issue Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications)
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14 pages, 434 KiB  
Review
Artificial Intelligence and Its Role in the Diagnosis and Prediction of Adverse Events in Acute Coronary Syndrome: A Narrative Review of the Literature
by Andrea Mariani, Carmen Anna Maria Spaccarotella, Francesco Saverio Rea, Anna Franzone, Raffaele Piccolo, Domenico Simone Castiello, Ciro Indolfi and Giovanni Esposito
Life 2025, 15(4), 515; https://doi.org/10.3390/life15040515 - 21 Mar 2025
Cited by 1 | Viewed by 670
Abstract
Acute coronary syndrome (ACS) is a global health concern that requires rapid and accurate diagnosis for timely intervention and better patient outcomes. With the emergence of Artificial Intelligence (AI), significant advancements have been made in improving diagnostic accuracy, efficiency, and risk stratification in [...] Read more.
Acute coronary syndrome (ACS) is a global health concern that requires rapid and accurate diagnosis for timely intervention and better patient outcomes. With the emergence of Artificial Intelligence (AI), significant advancements have been made in improving diagnostic accuracy, efficiency, and risk stratification in ACS management. This narrative review examines the current landscape of AI applications in ACS diagnosis and risk stratification, emphasizing key methodologies, technical and clinical implementation challenges, and also possible future research directions. Moreover, unlike previous reviews, this paper also focuses on ethical and legal issues and the feasibility of clinical applications. Full article
(This article belongs to the Special Issue Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications)
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