Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility
Abstract
:1. Introduction
2. Pathophysiology and Underlying Mechanisms of MINOCA
2.1. Coronary Physiology and Regulation of Coronary Blood Flow
2.2. MINOCA and Pathophysiological Mechanisms
3. Coronary Microvascular Dysfunction in MINOCA
4. Invasive and Non-Invasive Assessment of Coronary Microvascular Dysfunction
5. MINOCA and Coronary Microvascular Dysfunction: The Genetic Susceptibility
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Protein | Pathophysiological Mechanism | Reference |
---|---|---|
VEGF-A | Reduced expression → Repairing mechanisms abnormalities and increased apoptotic process → VSMCs and endothelial cells dysfunction → CMD | [88] |
CDKN2B-AS1 | Deficiency → abnormalities in VSMCs and endothelial cells proliferation and senescence → CMD | [88,89] |
HMOX | SNPs → reduced protection against ischemic injury → CMD | [92,93] |
ET-1 | SNP rs9349379-G → increased plasma concentration of ET-1 → vasomotor tone impairment and atherosclerotic disease progression → CAD and CMD | [94,95,96,97] |
eNOS | SNP rs1799983_G/T → substitution of guanine with thymine with consequent aminoacidic change from glutamic acid to aspartic acid → lower mRNA levels → reduction in eNOS expression → endothelial dysfunction → CAD and CMD | [98,99] |
K-ATP | SNP rs5215_G/G of KCNJ11 → valine–isoleucine substitution → K-ATP gain of function → increased vasodilation and shear stress reduction. | [100,101] |
NT5E | Genetic variants → CFR reduction and increased coronary calcification | [88,108] |
MYH15 | Deregulation of vascular tone → increased risk of CMD | [88] |
JAK2 | V617F mutation → endothelial dysfunction and coronary spasm | [109,110,111] |
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Severino, P.; D’Amato, A.; Prosperi, S.; Myftari, V.; Colombo, L.; Tomarelli, E.; Piccialuti, A.; Di Pietro, G.; Birtolo, L.I.; Maestrini, V.; et al. Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility. J. Clin. Med. 2023, 12, 3586. https://doi.org/10.3390/jcm12103586
Severino P, D’Amato A, Prosperi S, Myftari V, Colombo L, Tomarelli E, Piccialuti A, Di Pietro G, Birtolo LI, Maestrini V, et al. Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility. Journal of Clinical Medicine. 2023; 12(10):3586. https://doi.org/10.3390/jcm12103586
Chicago/Turabian StyleSeverino, Paolo, Andrea D’Amato, Silvia Prosperi, Vincenzo Myftari, Lorenzo Colombo, Elisa Tomarelli, Alice Piccialuti, Gianluca Di Pietro, Lucia Ilaria Birtolo, Viviana Maestrini, and et al. 2023. "Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility" Journal of Clinical Medicine 12, no. 10: 3586. https://doi.org/10.3390/jcm12103586