IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305175
Open Access Review
Coronary Artery Spasm: Risk Factors, Pathophysiological Mechanisms and Novel Diagnostic Approaches
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1 Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, China
2 Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, China
*Correspondence: shenyiwen@fudan.edu.cn (Yiwen Shen); liliangli11@fudan.edu.cn (Liliang Li)
These authors contributed equally.
Academic Editors: Brian Tomlinson and Takatoshi Kasai
Rev. Cardiovasc. Med. 2022, 23(5), 175; https://doi.org/10.31083/j.rcm2305175
Submitted: 28 December 2021 | Revised: 19 January 2022 | Accepted: 27 January 2022 | Published: 16 May 2022
(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Asia 2021)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Coronary artery spasm (CAS) is a transient reversible subtotal or complete occlusion induced by coronary hypercontraction and the critical cause of myocardial ischaemia with non-obstructive coronary arteries. During the past decades, our knowledge of the risk factors and pathophysiological mechanisms of CAS have been increasingly progressed, and various diagnostic approaches, including imaging technologies and novel biomarkers, have been proposed to serve well to diagnose CAS clinically. This review aims to summarize these research progresses on the risk factors of CAS and introduce current knowledge about the mechanisms accounting for CAS, including endothelial dysfunction, vascular smooth muscle cell hyperreactivity, and adventitial and perivascular adipose tissue inflammation. We also gathered the recently evolved diagnostic approaches and analyzed their advantages/disadvantages, in purpose of enhancing the diagnostic yield on the basis of ensuring accuracy.

Keywords
coronary artery spasm
risk factors
endothelial dysfunction
vascular smooth muscle cell hyperreactivity
adventitial inflammation
diagnostic approaches
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