无症状冠状动脉疾病患者的全球双心室功能障碍可能是由心肌炎引起的
A Frustaci1, C Chimenti, A Maseri
1Cardiology Institute, Catholic University, Rome, Italy.
Circulation
|March 17, 1999
概括
肌心炎可能导致无症状冠状动脉疾病的患者严重的双心脏功能障碍. 免疫抑制治疗改善了心脏功能,这表明炎症是这些心力衰竭病例的关键因素.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 无症状的关键冠状动脉阻塞在没有心肌梗塞的严重全球双心室功能障碍中的作用尚不清楚.
- 除了缺血事件之外,调查潜在的原因对于管理心力衰竭至关重要.
研究的目的:
- 为了确定严重的无症状冠状动脉疾病是否会导致全球双心室功能障碍.
- 探索心肌炎在这种情况下的潜在作用,并评估治疗结果.
主要方法:
- 研究了291名患有严重的全球双心室功能障碍的患者,使用心声学,心脏导管,冠状动脉血管学和内心肌活检.
- 对炎症 (心肌炎) 的活检样本进行分析,并评估心脏自身抗体.
- 使用免疫抑制疗法 (普雷尼松和阿扎西奥普林) 治疗活跃心肌炎患者的一个子组.
主要成果:
- 七名患者 (2.4%) 呈现严重的冠状动脉疾病和全球双心室功能障碍;活检证实了所有人的心肌炎.
- 接受免疫抑制治疗的患者在8个月内显著改善了心脏体积和功能.
- 传统治疗的患者没有改善,死亡率为1.
结论:
- 心肌炎是严重无症状冠状动脉疾病和没有先前心肌梗塞的患者全球双心室功能障碍的潜在原因.
- 心肌炎的组织学发现可以指导治疗决策,免疫抑制显示出有希望的结果.
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