Spasm, inflammation, coronary microcirculation and metabolism: how big is the iceberg under the stenosis


Spasm, inflammation, coronary microcirculation and metabolism:
how big is the iceberg under the stenosis
Doralisa Morrone MD, PhD
Division of Cardiology. Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine. University of Pisa, Italy

Abstract

Ischemic heart disease (IHD) is a leading global cause of death and coronary artery disease has long been considered the main determinant of inducible ischemia and symptoms. However, after the performance of hundreds of thousands of percutaneous coronary revascularizations (PCI) worldwide, outcome analysis suggests that the direct relationship between chronic obstructive coronary atherosclerosis and ischemic heart disease (IHD) may represent a too simplified view of IHD; growing evidence has demonstrated the importance of a number of other underlying mechanisms. The purpose of this review is to highlight the multiple mechanisms responsible of myocardial ischemia.

Key words: Ischemic heart disease; Chronic coronary syndromes; Percutaneous coronary intervention; Myocardial revascularization.


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