Role of optical coherence tomography in clinical manageme-nt of myocardial infarction with nonobstructive coronary ar-teries
Kenichi Tani1
Osamu Kurihara2
Akihiro Shirakabe1
Nobuaki Kobayashi2
Masamichi Taka-no2
Kuniya Asai3
1.Division of Intensive Care Unit,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan2.Cardiovascular Cen-ter,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan3.Division of Cardiology,Nippon Medical School,Tokyo,Japan
摘要：Myocardial infarction without angiographic moderate to severe stenosis(＞50％)and any other related diagnosis on clinical presentation is defined as myocardial infarction with nonobstructive coronary arteries(MINOCA).Common causes of MINOCA working diagnosis includes plaque disruption,spontaneous coronary artery dissection,coronary artery spasm,coron-ary thromboembolism,Takotsubo cardiomyopathy,and myocarditis.Clinical history,assay of myocardial enzymes,electrocardi-ogram,echocardiography,coronary angiography,and left ventriculography facilitate the initial diagnosis of MINOCA and rev-eal the underlying causes,while cardiovascular magnetic resonance and optical coherence tomography(OCT)are used to con-firm the diagnosis.Although cardiovascular magnetic resonance is the gold standard noninvasive diagnostic tool for MINOCA,its ability to diagnose the cause and mechanism underlying this condition in the coronary arteries is limited because of its image resolution.Observational studies have demonstrated that OCT can be used to determine the underlying cause of MINOCA by in-vestigating the characteristics of the culprit lesions and to predict the prognosis of the patients.In this article,we review the cur-rent diagnostic approach for MINOCA focusing on each imaging tool.Furthermore,we reevaluate the role of OCT in the clinical management of MINOCA.Identifying the cause of MINOCA through OCT might help select optimal and effective drug treatm-ents and improve prognosis.
机标关键词：tomographyclinicalrolewithar-teriescoherencecoronaryinfarction
论文发表日期：2024-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 1133-1140 )