: A significant proportion of patients presenting with signs and symptoms of myocardial ischemia have no "significant" epicardial disease; thereby, the assessment of coronary microcirculation gained an important role in improving diagnosis and guiding therapy. In fact, coronary microvascular dysfunction (CMD) could be found in a large proportion of these patients, supporting both symptoms and signs of myocardial ischemia. However, CMD represents a diagnostic challenge for two main reasons: (1) the small dimension of the coronary microvasculature prevents direct angiographic visualization, and (2) despite the availability of specific diagnostic tools, they remain invasive and underused in the current clinical practice. For these reasons, CMD remains underdiagnosed, and most of the patients remain with no specific treatment and quality-of-life-limiting symptoms. Of note, recent evidence suggests that a "full physiology" approach for the assessment of the whole coronary vasculature may offer a significant benefit in terms of symptom improvement among patients presenting with ischemia and non-obstructive coronary artery disease. We analyze the pathophysiology of coronary microvascular dysfunction, providing the readers with a guide for the invasive assessment of coronary microcirculation, together with the available evidence supporting its use in clinical practice.

Invasive Assessment of Coronary Microcirculation: A State-of-the-Art Review / Ciaramella, Luca; Di Serafino, Luigi; Mitrano, Lucia; De Rosa, Maria Luisa; Carbone, Carlo; Rea, Francesco Saverio; Monaco, Salvatore; Scalamogna, Maria; Cirillo, Plinio; Esposito, Giovanni. - In: DIAGNOSTICS. - ISSN 2075-4418. - 14:1(2023). [10.3390/diagnostics14010086]

Invasive Assessment of Coronary Microcirculation: A State-of-the-Art Review

Ciaramella, Luca;Di Serafino, Luigi;Mitrano, Lucia;De Rosa, Maria Luisa;Carbone, Carlo;Rea, Francesco Saverio;Monaco, Salvatore;Scalamogna, Maria;Cirillo, Plinio;Esposito, Giovanni
2023

Abstract

: A significant proportion of patients presenting with signs and symptoms of myocardial ischemia have no "significant" epicardial disease; thereby, the assessment of coronary microcirculation gained an important role in improving diagnosis and guiding therapy. In fact, coronary microvascular dysfunction (CMD) could be found in a large proportion of these patients, supporting both symptoms and signs of myocardial ischemia. However, CMD represents a diagnostic challenge for two main reasons: (1) the small dimension of the coronary microvasculature prevents direct angiographic visualization, and (2) despite the availability of specific diagnostic tools, they remain invasive and underused in the current clinical practice. For these reasons, CMD remains underdiagnosed, and most of the patients remain with no specific treatment and quality-of-life-limiting symptoms. Of note, recent evidence suggests that a "full physiology" approach for the assessment of the whole coronary vasculature may offer a significant benefit in terms of symptom improvement among patients presenting with ischemia and non-obstructive coronary artery disease. We analyze the pathophysiology of coronary microvascular dysfunction, providing the readers with a guide for the invasive assessment of coronary microcirculation, together with the available evidence supporting its use in clinical practice.
2023
Invasive Assessment of Coronary Microcirculation: A State-of-the-Art Review / Ciaramella, Luca; Di Serafino, Luigi; Mitrano, Lucia; De Rosa, Maria Luisa; Carbone, Carlo; Rea, Francesco Saverio; Monaco, Salvatore; Scalamogna, Maria; Cirillo, Plinio; Esposito, Giovanni. - In: DIAGNOSTICS. - ISSN 2075-4418. - 14:1(2023). [10.3390/diagnostics14010086]
File in questo prodotto:
File Dimensione Formato  
diagnostics Ciaramella.pdf

solo utenti autorizzati

Tipologia: Versione Editoriale (PDF)
Licenza: Accesso privato/ristretto
Dimensione 4.42 MB
Formato Adobe PDF
4.42 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/953607
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact