Godo Shigeo, Takahashi Jun, Shiroto Takashi, Yasuda Satoshi, Shimokawa Hiroaki
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.
Graduate School, International University of Health and Welfare Narita, Japan.
Eur Cardiol. 2023 Mar 21;18:e07. doi: 10.15420/ecr.2022.50. eCollection 2023.
Professor Maseri pioneered the research and treatment of coronary vasomotion abnormalities represented by coronary vasospasm and coronary microvascular dysfunction (CMD). These mechanisms can cause myocardial ischaemia even in the absence of obstructive coronary artery disease, and have been appreciated as an important aetiology and therapeutic target with major clinical implications in patients with ischaemia with non-obstructive coronary artery disease (INOCA). Coronary microvascular spasm is one of the key mechanisms responsible for myocardial ischaemia in patients with INOCA. Comprehensive assessment of coronary vasomotor reactivity by invasive functional coronary angiography or interventional diagnostic procedure is recommended to identify the underlying mechanisms of myocardial ischaemia and to tailor the best treatment and management based on the endotype of INOCA. This review highlights the pioneering works of Professor Maseri and contemporary research on coronary vasospasm and CMD with reference to endothelial dysfunction, Rho-kinase activation and inflammation.
马塞里教授率先开展了以冠状动脉痉挛和冠状动脉微血管功能障碍（CMD）为代表的冠状动脉血管舒缩异常的研究与治疗。这些机制即使在没有阻塞性冠状动脉疾病的情况下也可导致心肌缺血，并且已被视为无阻塞性冠状动脉疾病（INOCA）患者缺血的重要病因和具有重大临床意义的治疗靶点。冠状动脉微血管痉挛是INOCA患者心肌缺血的关键机制之一。建议通过有创功能性冠状动脉造影或介入诊断程序对冠状动脉血管舒缩反应性进行综合评估，以确定心肌缺血的潜在机制，并根据INOCA的亚型制定最佳治疗和管理方案。本综述着重介绍了马塞里教授的开创性工作以及当代关于冠状动脉痉挛和CMD的研究，涉及内皮功能障碍、Rho激酶激活和炎症。
