ArticleClinical research in cardiology : official journal of the German Cardiac Society2024
Coronary microvascular dysfunction is a hallmark of all subtypes of MINOCA.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 9 citations in OpenAlex.
- Early quantitative stress-perfusion cardiac magnetic resonance reveals perfusion abnormalities consistent with coronary microvascular dysfunction in MINOCA patients with otherwise normal cardiac magnetic resonance findings.Scientific reports · 2026Article
- Molecular mechanisms of coronary microembolization-induced MINOCA.Basic research in cardiology · 2026Review
- Diagnostic relevance of angiography-derived coronary microcirculatory resistance in sudden cardiac death.Quantitative imaging in medicine and surgery · 2026Article
- Prognostic Impact of Infarct Size and Coronary Microvascular Function Via Cardiovascular Magnetic Resonance and Coronary Angiography-Derived Index of Microcirculatory Resistance in Myocardial Infarction With Nonobstructive Coronary Arteries.Journal of the American Heart Association · 2026Observational
- From Echo to Coronary Angiography: Optimizing Ischemia Evaluation Through Multimodal Imaging.Medicina (Kaunas, Lithuania) · 2025Review
- Myocardial ischemia in nonobstructive coronary arteries: A review of diagnostic dilemmas, current perspectives, and emerging therapeutic innovations.World journal of cardiology · 2025Review
- Factors Contributing to Coronary Microvascular Dysfunction in Patients with Angina and Non-Obstructive Coronary Artery Disease.Journal of cardiovascular development and disease · 2024Article
- Impact of Coronary Microvascular Dysfunction in Takotsubo Syndrome: Cause, Consequence or Both?Reviews in cardiovascular medicine · 2024Review
- Endothelial Dysfunction and Heart Failure with Preserved Ejection Fraction-An Updated Review of the Literature.Life (Basel, Switzerland) · 2023Review
- Reduced stress perfusion in myocardial infarction with nonobstructive coronary arteries.Scientific reports · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMyocardial infarction without obstructive coronary artery disease (MINOCA) is a heterogeneous clinical condition presenting with myocardial necrosis not due to an obstruction of a major coronary artery. Recently, a relevant role of coronary microvascular dysfunction (CMD) in the pathogenesis of MINOCA has been suggested; however, data on this are scarce. Particularly, it is unclear if CMD is equally present in all subtypes of MINOCA or differentially identifies one or more of these conditions. Therefore, the aim of this study was to assess CMD in all three coronary vessels of MINOCA patients, relating it with the clinical subtype.
methodsWe retrospectively assessed coronary microvascular function in all three coronary territories by means of angiography-based index of microvascular resistance (aIMR) in 92 patients (64 with working diagnosis of MINOCA, 28 control patients). To further assess the association of CMD with MINOCA subtypes, MINOCA patients were subdivided according to clinical data in coronary cause (n = 13), takotsubo (n = 13), infiltrative or inflammatory cardiomyopathy (n = 9) or unclear (n = 29).
resultsPatients with working diagnosis of MINOCA showed a significantly elevated average aIMR compared to control patients (30.5 ± 7.6 vs. 22.1 ± 5.9, p < 0.001) as a marker of a relevant CMD; these data were consistent in all vessels. Among MINOCA subtypes, no significant difference in average aIMR could be detected between patients with coronary cause (33.2 ± 6.6), takotsubo cardiomyopathy (29.2 ± 6.9), infiltrative or inflammatory cardiomyopathy (28.1 ± 6.8) or unclear cause (30.6 ± 8.5; p = 0.412). Interestingly, aIMR was significantly elevated in the coronary vessel supplying the diseased myocardium compared with other vessels (31.9 ± 11.4 vs. 27.8 ± 8.2, p = 0.049).
conclusionCoronary microvascular dysfunction is a hallmark of all MINOCA subtypes. This study adds to the pathophysiological understanding of MINOCA and sheds light into the role of CMD in MINOCA.
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