Ischemia With Nonobstructive Coronary Artery Disease

作者：Doyeon Hwang, Sang-Hyeon Park, Bon‐Kwon Koo · 发表于：JACC Asia · 年份：2023 · DOI：10.1016/j.jacasi.2023.01.004 · 被引用次数：43 · 研究领域：Cardiac Imaging and Diagnostics、Cardiovascular Function and Risk Factors、Cardiac electrophysiology and arrhythmias

In daily clinical practice, physicians often encounter patients with angina or those with evidence of myocardial ischemia from noninvasive tests but not having obstructive coronary artery disease. This type of ischemic heart disease is referred to as ischemia with nonobstructive coronary arteries (INOCA). INOCA patients often suffer from recurrent chest pain without adequate management and are associated with poor clinical outcomes. There are several endotypes of INOCA, and each endotype should be treated based on its specific underlying mechanism. Therefore, identifying INOCA and discriminating its underlying mechanisms are important issues and of clinical interest. Invasive physiologic assessment is the first step in the diagnosis of INOCA and discriminating the underlying mechanism; additional provocation tests help physicians identify the vasospastic component in INOCA patients. Comprehensive information acquired from these invasive tests can provide a template for mechanism-specific management for patients with INOCA.