Key result
Coronary functional assessment provides valuable pathophysiological insights and helps guide individualized treatment strategies for patients with non-obstructive coronary artery disease.
Why the study?
Routine coronary functional assessment in non-obstructive CAD is limited despite its ability to elucidate pathophysiological mechanisms and exclude specific etiologies.
This review summarizes the pathophysiological mechanisms of INOCA and MINOCA and highlights the role of various invasive and non-invasive coronary functional assessment indices in their diagnosis and management.
Functional evaluation may clarify mechanisms in non-obstructive CAD; leaves open standardization for routine use.
Non-obstructive coronary artery disease (CAD), which is defined as coronary stenosis <50%, has been increasingly recognized as an emerging entity in clinical practice. Vasomotion abnormality and coronary microvascular dysfunction are two major mechanisms contributing to the occur of angina with non-obstructive CAD. Although routine coronary functional assessment is limited due to several disadvantages, functional evaluation can help to understand the pathophysiological mechanism and/or to exclude specific etiologies. In this review, we summarized the potential mechanisms involved in ischemia with non-obstructive coronary arteries (INOCA) and myocardial infarction with non-obstructive coronary arteries (MINOCA), the two major form of non-obstructive CAD. Additionally, we reviewed currently available functional assessment indices and their use in non-obstructive CAD. Furthermore, we speculated that novel technique combined anatomic and physiologic parameters might provide more individualized therapeutic choice for patients with non-obstructive CAD.
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Zhai et al. (2022) conducted a review in Non-obstructive coronary artery disease (INOCA and MINOCA). Coronary functional assessment was evaluated. Coronary functional assessment provides valuable pathophysiological insights and helps guide individualized treatment strategies for patients with non-obstructive coronary artery disease.
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