Myocardial ischemia: From disease to syndrome

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:314

Article

Marzilli, Mario¹  Crea, Filippo²  Morrone, Doralisa¹  Bonow, Robert O.³  Brown, David L.⁴  Camici, Paolo G.^5,6  Chilian, William M.⁷  DeMaria, Anthony⁸  Guarini, Giacinta¹  Huqi, Alda¹  Merz, C. Noel Bairey⁹  Pepine, Carl¹⁰  Scali, Maria Chiara¹  Weintraub, William S.¹¹  Boden, William E.¹² 

[1] Univ Pisa, Dept Surg Med Mol & Crit Area Pathol, Pisa, Italy

[2] Univ Cattolica Sacro Cuore, Inst Cardiol, Rome, Italy

[3] Northwestern Univ, Dept Med, Chicago, IL 60611 USA

[4] Washington Univ, Sch Med, Cardiovasc Div, St Louis, MO USA

[5] Univ Vita Salute San Raffaele, Milan, Italy

[6] Osped San Raffaele, Milan, Italy

[7] Northeast Ohio Med Univ, Dept Integrat Med Sci, Rootstown, OH USA

[8] Univ Calif San Diego, Div Cardiol, San Diego, CA 92103 USA

[9] Cedars Sinai Smidt Heart Inst, Barbra Streisand Womens Heart Ctr, Los Angeles, CA USA

[10] Univ Florida, Dept Med, Div Cardiol, Gainesville, FL USA

[11] MedStar Washington Hosp Ctr, MedStar Heart & Vasc Inst, Outcomes Res, Seattle, WA USA

[12] VA New England Hlth Care Syst, Boston, MA USA

关键词: Ischemic heart disease;    Microvascular dysfunction;    Coronary artery disease;    Angina;    Chronic coronary syndromes;   

DOI  :  10.1016/j.ijcard.2020.04.074

来源: Elsevier

【 摘 要 】

Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore howthe awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition. (c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

【 授权许可】

Free