Spînu Mihail, Onea Laurenţiu Horea, Homorodean Călin, Olinic Maria, Ober Mihai Claudiu, Olinic Dan Mircea
Medical Clinic Number 1, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania.
J Clin Med. 2022 Jan 5;11(1):265. doi: 10.3390/jcm11010265.
Cardiovascular diseases are the main cause of death worldwide, with coronary artery disease being the predominant underlying etiology. The most prevalent coronary lesions are represented by the atherosclerotic plaques, in more than 85% of cases, but there are several other non-atherosclerotic lesions such as spontaneous coronary artery dissection and/or hematoma and spontaneous recanalization of coronary thrombus, which are less common, approximately 5% of cases, but with similar clinical manifestations as well as complications. There are insufficient data regarding the pathological mechanism, true prevalence and optimal treatment of these kind of coronary lesions. Optical coherence tomography (OCT) is an intracoronary imaging technique, developed in order to overcome the diagnostic limitations of a standard coronary angiography and has an extremely high resolution, similar to that of a usual histological evaluation of a biopsy sample, thus, OCT provides a histological-like information, but in a in vivo environment. The aim of this article is to review the current knowledge regarding non-atherosclerotic coronary lesions, with an emphasis on the importance of OCT for optimal identification, characterization of pathogenic mechanisms and optimal treatment selection.
心血管疾病是全球主要的死亡原因，冠状动脉疾病是主要的潜在病因。在超过85%的病例中，最常见的冠状动脉病变是动脉粥样硬化斑块，但还有其他几种非动脉粥样硬化病变，如自发性冠状动脉夹层和/或血肿以及冠状动脉血栓的自发性再通，这些病变不太常见，约占病例的5%，但其临床表现和并发症相似。关于这类冠状动脉病变的病理机制、真实患病率和最佳治疗方法的数据不足。光学相干断层扫描（OCT）是一种冠状动脉内成像技术，旨在克服标准冠状动脉造影的诊断局限性，具有极高的分辨率，类似于活检样本的常规组织学评估，因此，OCT提供了类似组织学的信息，但却是在体内环境中。本文的目的是综述关于非动脉粥样硬化性冠状动脉病变的当前知识，重点强调OCT对于最佳识别、致病机制的特征描述和最佳治疗选择的重要性。
