Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility
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 i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/10/3586 |
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| author | Paolo Severino Andrea D’Amato Silvia Prosperi Vincenzo Myftari Lorenzo Colombo Elisa Tomarelli Alice Piccialuti Gianluca Di Pietro Lucia Ilaria Birtolo Viviana Maestrini Roberto Badagliacca Gennaro Sardella Francesco Fedele Carmine Dario Vizza Massimo Mancone |
| author_facet | Paolo Severino Andrea D’Amato Silvia Prosperi Vincenzo Myftari Lorenzo Colombo Elisa Tomarelli Alice Piccialuti Gianluca Di Pietro Lucia Ilaria Birtolo Viviana Maestrini Roberto Badagliacca Gennaro Sardella Francesco Fedele Carmine Dario Vizza Massimo Mancone |
| author_sort | Paolo Severino |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T03:37:21Z |
| format | Article |
| id | doaj.art-4ba46270ebe64e93945d10a0288f8b77 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:37:21Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4ba46270ebe64e93945d10a0288f8b772023-11-18T01:55:31ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-011210358610.3390/jcm12103586Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic SusceptibilityPaolo Severino0Andrea D’Amato1Silvia Prosperi2Vincenzo Myftari3Lorenzo Colombo4Elisa Tomarelli5Alice Piccialuti6Gianluca Di Pietro7Lucia Ilaria Birtolo8Viviana Maestrini9Roberto Badagliacca10Gennaro Sardella11Francesco Fedele12Carmine Dario Vizza13Massimo Mancone14Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyAmong 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.https://www.mdpi.com/2077-0383/12/10/3586MINOCAINOCAcoronary microvascular dysfunctioncoronary flow reserveindex of microvascular resistancegenetic predisposition |
| spellingShingle | Paolo Severino Andrea D’Amato Silvia Prosperi Vincenzo Myftari Lorenzo Colombo Elisa Tomarelli Alice Piccialuti Gianluca Di Pietro Lucia Ilaria Birtolo Viviana Maestrini Roberto Badagliacca Gennaro Sardella Francesco Fedele Carmine Dario Vizza Massimo Mancone Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility Journal of Clinical Medicine MINOCA INOCA coronary microvascular dysfunction coronary flow reserve index of microvascular resistance genetic predisposition |
| title | Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility |
| title_full | Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility |
| title_fullStr | Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility |
| title_full_unstemmed | Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility |
| title_short | Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility |
| title_sort | myocardial infarction with non obstructive coronary arteries minoca focus on coronary microvascular dysfunction and genetic susceptibility |
| topic | MINOCA INOCA coronary microvascular dysfunction coronary flow reserve index of microvascular resistance genetic predisposition |
| url | https://www.mdpi.com/2077-0383/12/10/3586 |
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