在患有耐火性胸痛的患者中,通过心肌激光再血管化后的中期临床结果
C K Landolfo1, K P Landolfo, G C Hughes
1Duke University Medical Center, Departments of Internal Medicine, Surgery, and Radiology, Division of Cardiology, Durham, NC 27710, USA. donov001@mc.duke.edu
Circulation
|November 24, 1999
概括
透心肌激光复血管 (TMR) 为末期冠状动脉疾病患者提供适度,持续的心痛缓解. 虽然TMR没有改善SPECT输液成像,但50%的患者在一年内经历了 angina 症状的改善.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗技术 医疗技术 医学技术
背景情况:
- 耐火性胸痛对于那些不适合传统治疗的患者来说是一个挑战.
- 跨心肌激光复血管 (TMR) 是心肌缺血症的替代性手术选择.
- 关于TMR的长期疗效和自然史的数据有限.
研究的目的:
- 评估心肌透射激光复血管化 (TMR) 的中期临床结果.
- 评估TMR后耐火性胸痛患者的临床改善的持续时间.
主要方法:
- 34名患有严重冠状动脉疾病的患者接受了TMR.
- 术前的SPECT (201) Tl输液成像用于确定缺血性心肌区域.
- 临床结局包括死亡率,心肌梗塞,胸痛类和住院病例在TMR后3,6和12个月被评估.
主要成果:
- 一年死亡率为14.7%,8.8%的人经历了非致命的心肌梗塞.
- 平均心痛级别从TMR前的3.5提高到12个月后的2.8 (n=27).
- 50%的患者在1年内表现出心痛类持续改善;因心痛不稳定而住院的病例显著下降 (P=0.01).
结论:
- 透心肌激光复血管化 (TMR) 在末期冠状动脉疾病患者的胸痛症状中提供了适度但持续的改善.
- 临床益处,特别是症状改善,在TMR后6个月达到峰值,并在1年后在50%的患者中保持.
- SPECT (201) Tl成像在TMR后没有显示显著的输液改善,这表明症状缓解可能通过非缺血机制进行调解.
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