慢性冠状动脉全封闭的微血管功能障碍
G S Werner1, M Ferrari, B M Richartz
1Clinic for Internal Medicine III, Friedrich-Schiller-University Jena, Erlanger Allee 101, Jena, Germany. gerald.werner@med.uni-jena.de
Circulation
|September 6, 2001
概括
微血管功能障碍影响了超过一半的慢性冠状动脉全封闭 (TCO) 患者,特别是糖尿病或高血压患者. 结合冠状动脉流速储备 (CFVR) 和分流储备 (FFR) 对于TCO血管造形术后的准确评估至关重要.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 冠状动脉疾病 冠状动脉疾病
背景情况:
- 微血管功能障碍的特征是冠状动脉流量储备减少,而无表心狭窄.
- 这项研究调查了慢性冠状动脉全封闭 (TCOs) 中微血管功能障碍的患病率和影响.
研究的目的:
- 为了确定TCOs中微血管功能障碍的患病率.
- 评估微血管功能障碍与区域性心肌功能之间的关系.
- 评估冠状动脉流速储备 (CFVR) 和部分流量储备 (FFR) 在TCOs中的实用性.
主要方法:
- 在42名患者中,TCOs的再通道化和支架.
- 冠状动脉流速储备 (CFVR) 用冠状动脉内多普勒测量.
- 在27名患者的子集中记录了部分流量储备 (FFR).
- 在21名患者中,CFVR在24小时后重新评估.
主要成果:
- 55%的患者表现出降低的CFVR (<2.0).
- 在一个子组中,52%的患者显示CFVR降低,FFR不显著 (>=0.75),表明微血管功能障碍.
- 微血管功能障碍在糖尿病和/或高血压患者中更为普遍.
- CFVR和FFR的相关性很差 (r=0.03).
结论:
- 微血管功能障碍在TCO中很常见 (55%),无论心肌功能区域如何.
- 糖尿病和高血压与增加的微血管功能障碍有关.
- 单独的CFVR和FFR都不足以评估TCO中的血管形成术结果;建议进行联合评估.
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