Galante Domenico, La Vecchia Giulia, Leone Antonio Maria, Crea Filippo
Center of Excellence of Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy.
Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Kardiol Pol. 2025;83(3):269-276. doi: 10.33963/v.phj.105217. Epub 2025 Mar 13.
Coronary microvascular dysfunction encompasses a wide variety of structural and/or functional abnormalities of the coronary microcirculation which are key determinants of myocardial ischemia in patients with angina and non-obstructive coronary artery disease, as well as in several other cardiovascular conditions. The diagnosis is based on the demonstration of an impaired vasodilator capacity and/or the evidence of microvascular spasm by invasive coronary angiography. Despite its relevant clinical and prognostic implications, there are no specific treatments to date specifically addressing coronary microvascular dysfunction. In this review article, we aimed to provide an overview of the pathophysiology, diagnostic work-up, and therapeutic management of patients with angina and non-obstructive coronary artery disease, focusing on emerging biomarkers, novel therapeutic targets, and remaining knowledge gaps and unmet needs.
冠状动脉微血管功能障碍包括冠状动脉微循环的多种结构和/或功能异常，这些异常是心绞痛和非阻塞性冠状动脉疾病患者以及其他几种心血管疾病中心肌缺血的关键决定因素。诊断基于侵入性冠状动脉造影显示的血管舒张能力受损和/或微血管痉挛的证据。尽管其具有相关的临床和预后意义，但迄今为止尚无专门针对冠状动脉微血管功能障碍的特异性治疗方法。在这篇综述文章中，我们旨在概述心绞痛和非阻塞性冠状动脉疾病患者的病理生理学、诊断检查和治疗管理，重点关注新兴生物标志物、新的治疗靶点以及尚存的知识空白和未满足的需求。
