{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:03:07Z","timestamp":1791237787851,"version":"4.1.0"},"reference-count":193,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Coronary vasomotor disorders (CVD) are characterized by transient hypercontraction of coronary vascular smooth muscle cells, leading to hypercontraction of epicardial and\/or microvascular coronary circulation. CVDs play a relevant role in the pathogenesis of ischemia, angina and myocardial infarction with non-obstructive coronary arteries. Invasive provocative testing with intracoronary Acetylcholine (ACh) administration is the gold standard tool for addressing CVD, providing relevant therapeutic and prognostic implications. However, safety concerns preclude the widespread incorporation of the ACh test into clinical practice. The purpose of this review is to shed light on the pathophysiology underlying CVD and on the clinical role of the ACh test, focusing on safety profile and prognostic implications. We will also discuss contemporary evidence on the management of CVD and the role of the ACh test in driving a personalized approach of patients with CVD.<\/jats:p>","DOI":"10.3390\/life14030292","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T08:34:35Z","timestamp":1708590875000},"page":"292","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders"],"prefix":"10.3390","volume":"14","author":[{"given":"Filippo Luca","family":"Gurgoglione","sequence":"first","affiliation":[{"name":"Division of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Vignali","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Parma University Hospital, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6439-1018","authenticated-orcid":false,"given":"Rocco Antonio","family":"Montone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0559-2626","authenticated-orcid":false,"given":"Riccardo","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Benatti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Parma University Hospital, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Solinas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Parma University Hospital, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1276-9883","authenticated-orcid":false,"given":"Antonio Maria","family":"Leone","sequence":"additional","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina, Gemelli Isola Roma, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Galante","sequence":"additional","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina, Gemelli Isola Roma, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-188X","authenticated-orcid":false,"given":"Gianluca","family":"Campo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-2370","authenticated-orcid":false,"given":"Simone","family":"Biscaglia","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Italo","family":"Porto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Genoa, 16126 Genoa, Italy"},{"name":"Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino\u2014Italian IRCCS Cardiology Network, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Benenati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Genoa, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampaolo","family":"Niccoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Parma University Hospital, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3504","DOI":"10.1093\/eurheartj\/ehaa503","article-title":"An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group","volume":"41","author":"Kunadian","year":"2020","journal-title":"Eur. 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