冠状动脉非阻塞性心肌梗死病因及腔内影像学特征OA

Non-obstructive myocardial infarction of the coronary artery(MINOCA)is a form of acute myocardial infarction(AMI)characterized by less than 50%stenosis on coronary angiography,accounting for approximately 5%to 15%of all AMI cases.Its etiology is highly heterogeneous,encompassing plaque rupture,plaque erosion,calcified nodules,vascular spasm,mi-crovascular dysfunction,spontaneous coronary artery dissection,and coronary artery embolism or thrombosis,etc.The prognosis of MINOCA patients varies significantly depending on the underlying etiology.Intravascular imaging techniques,such as optical coherence tomography and intravascular ultrasound,offer significant advantages in diagnosing plaque lesions,coronary artery spasm,spontaneous coronary artery dissection,and thrombus.However,they are limited in assessing microvascular spasm and non-coronary artery etiologies.Although research on MINOCA is ongoing,systematic investigations into its etiology and intravas-cular imaging characteristics remain limited.This review aims to synthesize recent research on the pathogenesis,intracoronary im-aging findings,and clinical outcomes of MINOCA for the purpose of improving clinical recognition of physicians towards MINO-CA and providing theoretical basis for developing relevant secondary prevention strategy.