Lanza Gaetano Antonio
Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Cardiology Institute Rome, Italy.
Eur Cardiol. 2019 Jul 11;14(2):97-102. doi: 10.15420/ecr.2019.22.2. eCollection 2019 Jul.
The diagnosis of microvascular angina (MVA) is usually considered in patients presenting with angina symptoms and evidence of MI on non-invasive stress tests but normal coronary arteries at angiography. A definitive diagnosis of MVA, however, would require the presence of coronary microvascular dysfunction. Several invasive (e.g. intracoronary Doppler wire recording and thermodilution) and non-invasive (e.g. PET, cardiac MRI, transthoracic Doppler echocardiography) methods can be applied to obtain a diagnosis. Both endothelium-dependent and -independent coronary microvascular dilator function, as well as increased microvascular constrictor activity, should be investigated. The main issues in the assessment of clinical and diagnostic findings in patients with suspected MVA are discussed and a diagnostic approach is suggested.
微血管性心绞痛（MVA）的诊断通常适用于出现心绞痛症状且无创负荷试验有心肌梗死证据但血管造影显示冠状动脉正常的患者。然而，MVA的明确诊断需要存在冠状动脉微血管功能障碍。可以应用几种有创（如冠状动脉内多普勒导丝记录和热稀释法）和无创（如正电子发射断层扫描、心脏磁共振成像、经胸多普勒超声心动图）方法来进行诊断。应研究内皮依赖性和非依赖性冠状动脉微血管扩张功能以及微血管收缩活性增加的情况。本文讨论了疑似MVA患者临床和诊断结果评估中的主要问题，并提出了一种诊断方法。
