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バリアント・アンギナ・ペクトリス. 固定冠動脈阻害の発達における冠動脈の役割
J C Kaski1, D Tousoulis, E McFadden
1Cardiovascular Research Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Circulation
|February 1, 1992
まとめ
Prinzmetalの変異性アンギナにおける再発性冠動脈は,的な部位での狭窄症の進行を頻繁に引き起こさなかった. この研究では,時を経て繰り返される閉塞性にかかわらず,冠動脈直径の最小限の変化が見つかりました.
科学分野:
- 心臓病学 心臓病学
- 血管生物学 血管生物学
- 介入性心臓病学 介入性心臓病学
背景:
- 繰り返される冠動脈は,固定された動脈硬化阻害に寄与すると仮定されています.
- Prinzmetalの変異性アンギナは,動的,可逆的な冠動脈狭窄によって特徴付けられています.
- 発作が冠動脈動脈硬化に及ぼす長期的な影響を理解することは,患者の管理に極めて重要です.
研究 の 目的:
- 繰り返される焦点冠動脈が,Prinzmetalの変異性アンギナ患者の冠動脈狭窄の進行につながるかどうかを調査する.
- 重複性の部位における冠動脈直径の変化を,重要な追跡期間中に評価する.
主な方法:
- Prinzmetalの変異性アンギナが活発な10人の患者からなるコホートは,繰り返し冠動脈動脈造影を受けた.
- コンピューター製の動脈撮影は,スパスティックおよび非スパスティック冠動脈のセグメントにおける狭窄の進行を評価するために使用されました.
- 冠動脈の直径と狭窄の重さは,初期およびフォローアップ血管図 (25 +/- 12ヶ月間隔) の間で比較されました.
主要な成果:
- 10人中9人の患者では,以前に特定された狭窄部位 (直径の20~65%の縮小) でが起こりました.
- スパスティック,非スパスティック・ステノティック,または正常な非スパスティックセグメントの初期およびフォローアップ動脈図の間では,平均直径の有意な違いは観察されなかった.
- 狭窄症の進行が完全閉塞に至ったのは,スパスティック部位のある1人の患者と,スパスティック部位でない2人の患者で発生した.
結論:
- 慢性的なプリンツメタルの変異性アンギナ (心筋梗塞なし) の患者における再発的焦点冠動脈は,縮部位での狭窄症の進行をしばしば引き起こすことはなかった.
- この結果から,冠動脈は,観察された期間中,この患者集団における固定性動脈硬化病変の発症の主な要因ではない可能性があることが示唆される.
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