Among the most common causes of death worldwide, ischemic heart disease (IHD) is recognized to rank first. Even if atherosclerotic disease of the epicardial arteries is known as the leading cause of IHD, the presence of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasingly recognized. Notwithstanding the increasing interest, MINOCA remains a puzzling clinical entity that can be classified by distinguishing different underlying mechanisms, which can be divided into atherosclerotic and non-atherosclerotic. In particular, coronary microvascular dysfunction (CMD), classifiable in non-atherosclerotic mechanisms, is a leading factor for the pathophysiology and prognosis of patients with MINOCA. Genetic susceptibility may have a role in primum movens in CMD. However, few results have been obtained for understanding the genetic mechanisms underlying CMD. Future studies are essential in order to find a deeper understanding of the role of multiple genetic variants in the genesis of microcirculation dysfunction. Progress in research would allow early identification of high-risk patients and the development of pharmacological, patient-tailored strategies. The aim of this review is to revise the pathophysiology and underlying mechanisms of MINOCA, focusing on CMD and actual knowledge about genetic predisposition to it.

Myocardial infarction with non-obstructive coronary arteries (MINOCA. focus on coronary microvascular dysfunction and genetic susceptibility / Severino, Paolo; D'Amato, Andrea; Prosperi, Silvia; Myftari, Vincenzo; Colombo, Lorenzo; Tomarelli, Elisa; Piccialuti, Alice; Di Pietro, Gianluca; Birtolo, Lucia Ilaria; Maestrini, Viviana; Badagliacca, Roberto; Sardella, Gennaro; Fedele, Francesco; Vizza, Carmine Dario; Mancone, Massimo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:10(2023). [10.3390/jcm12103586]

Myocardial infarction with non-obstructive coronary arteries (MINOCA. focus on coronary microvascular dysfunction and genetic susceptibility

Severino, Paolo;D'Amato, Andrea;Prosperi, Silvia;Myftari, Vincenzo;Colombo, Lorenzo;Tomarelli, Elisa;Di Pietro, Gianluca;Birtolo, Lucia Ilaria;Maestrini, Viviana;Badagliacca, Roberto;Sardella, Gennaro;Fedele, Francesco;Vizza, Carmine Dario;Mancone, Massimo
2023

Abstract

Among the most common causes of death worldwide, ischemic heart disease (IHD) is recognized to rank first. Even if atherosclerotic disease of the epicardial arteries is known as the leading cause of IHD, the presence of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasingly recognized. Notwithstanding the increasing interest, MINOCA remains a puzzling clinical entity that can be classified by distinguishing different underlying mechanisms, which can be divided into atherosclerotic and non-atherosclerotic. In particular, coronary microvascular dysfunction (CMD), classifiable in non-atherosclerotic mechanisms, is a leading factor for the pathophysiology and prognosis of patients with MINOCA. Genetic susceptibility may have a role in primum movens in CMD. However, few results have been obtained for understanding the genetic mechanisms underlying CMD. Future studies are essential in order to find a deeper understanding of the role of multiple genetic variants in the genesis of microcirculation dysfunction. Progress in research would allow early identification of high-risk patients and the development of pharmacological, patient-tailored strategies. The aim of this review is to revise the pathophysiology and underlying mechanisms of MINOCA, focusing on CMD and actual knowledge about genetic predisposition to it.
2023
INOCA; MINOCA; coronary flow reserve; coronary microvascular dysfunction; genetic predisposition; index of microvascular resistance
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Myocardial infarction with non-obstructive coronary arteries (MINOCA. focus on coronary microvascular dysfunction and genetic susceptibility / Severino, Paolo; D'Amato, Andrea; Prosperi, Silvia; Myftari, Vincenzo; Colombo, Lorenzo; Tomarelli, Elisa; Piccialuti, Alice; Di Pietro, Gianluca; Birtolo, Lucia Ilaria; Maestrini, Viviana; Badagliacca, Roberto; Sardella, Gennaro; Fedele, Francesco; Vizza, Carmine Dario; Mancone, Massimo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:10(2023). [10.3390/jcm12103586]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1686954
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