According to the recent report from the world heart federation(WHF), a staggering 20.5 million global deaths were attributed to cardiovascular disease in 2021, a notable increase from the 12.1 million reported in 1999.Nowadays, ischemia emerges as a prominent factor, representing a tradable main problem that poses a formidable challenge.Conventional cardi- ology treatments often encounter limitations, compelling a shift towards invasive strategies like heart transplants or percutaneous interventions such fas stinting, even in cases of sta- ble chronic ischemia.To overcome the limitations of established cardiovascular treatments, cutting-edge technologies based on arti cial intelligence(AI) can play a signi cant role in supporting and enhancing these treatments.In this context, the main objective of this pa- per is to spotlight a spectrum of non-invasive strategies that have recently surfaced through the implementation of AI technologies.Our focus will center on capturing recent relevant studies and successful approaches of microvascular dysfunction detection clinical scenarios coupled with AI models and technologies to actively support and enhance our understanding of contexts related to stable ischemic heart disease(SIHD).This investigation aims to pro- vide a comprehensive overview of the progress made in employing AI techniques to address the challenges posed by ischemia, including an exploration of suitable data types and their combination.Furthermore, the discussion will extend to newly duced approaches aimed at pro ciently reversing the impact of ischemia.

Patients with chest pain and non-obstructive CAD have a high prevalence of coronary microvascular abnormalities.These abnormalities correlate poorly with conventional cardio- vascular risk factors and are dissociated from classical ndings of non-invasive functional testing[407, 367, 1], partly due to the lower microvascular arterial compliance characteristic of these patients[408, 409, 410, 10, 411, 412]after a deep research in articles it seems like that CMD signature it hard to capture due too multifaceted factors those intervenes and contribute to CMD development mechanisms[413, 414], Beyond the relevance of temporal ef- fects commonly investigated in relation to atherosclerotic progression and plaque morphology both before and after PCI the most salient observation in this area of cardiovascular disease research is the considerable disparity between the clinical scenarios proposed and the current capacity to adhere them with analytical or numerical models within realistic, AI-assisted sim- ulation environments. due too rarity of micro-coronary databases and personalized contexts de nition[415],CMD progression had overcome formal and familiar organic techniques of di- agnostic and prognosis to be projected in the psychiatry area and mental health[131, 416], sex di erentiation[8][417, 418, 419, 375, 168, 178]switch international statistics women’s are the most a ected by that syndrome related to postmenopausal period, microvascular dys- function syndrome interacts in a complex often bidirectional or multidirectional manner with various cardiovascular risk factors. In some studies, it is hypothesized as a central mech- anism the evaluation invasive indices such as(CBF, and FFR)concatenated to cardiologist expertise.Alternatively, it may also be considered as a predictive element inferred from ap- parent clinical risk factors [420, 421].Establishing a clear and standardized framework for the study of CMD remains a signi cant challenge, largely due to the multidisciplinary nature of the eld.E ective representation of the problem requires contributions from diverse domains such as physics, computational modelling and arti cial intelligence[115] Although restoring epicardial blood ow after AMI represents the cornerstone of therapeutic strategies[422], CMD continues to exert a decisive in uence, particularly in clinical entities such as INOCA and ANOCA[423].The interplay between anatomical and functional characteristics of coro- nary stenosis as a key element[424]highlighted in studies on coronary microembolization[425] [426, 427]rheumatoid diseases, epicardial vascular dysfunction[428, 372, 248]CMD discov- ering has been related to the justi cation of revascularization as choice to regulate blood ow[429].A major determinant of outcome in patients with MVA and NoCAD seems instead related to non-critical atherosclerotic disease suggesting a more aggressive management of cardiovascular risk factors and preventive management[430]multimodality approach complex- ity controlling, coronary microcirculatory pathophysiology can we a ord it to remain a black box axel pries that persist as he principal dielemma[431, 432]relationship of macrocircula- tion to microcirculation[433]PCI utility after folow up and some medication e ects[372]as β blockers on stable angina development to ischemia[434, 21, 435] recommandation[395] , this article was an attempt to de ne the contexts for the onset of microvascular dysfunction, but there is as yet no well-de ned formula for detecting the development of CMD with normal coronary arteries.

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