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冠状动脉血管内皮功能障碍的预后值
Julian P J Halcox1, William H Schenke, Gloria Zalos
1Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md, USA.
Circulation
|August 7, 2002
概括
冠状动脉内皮功能障碍,特别是微血管和表心反应,预测冠状动脉疾病 (CAD) 患者和没有冠状动脉疾病 (CAD) 患者的心血管事件. 这种测试提供了超越传统风险因素的有价值的预后信息.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 预防医学 预防医学
背景情况:
- 在不同人群中评估心血管风险仍然具有挑战性.
- 冠状动脉血管功能测试对急性事件的预测价值尚未完全理解.
- 在患有冠状动脉样硬化 (CAD) 和没有冠状动脉样硬化 (CAD) 的患者中调查冠状动脉内皮功能至关重要.
研究的目的:
- 为了确定冠状动脉内皮功能测试是否可以识别患有急性心血管事件风险增加的患者.
- 评估患有或没有CAD的患者内皮功能和心血管结果之间的关系.
- 评估冠状动脉血管功能测试的预后价值.
主要方法:
- 冠状动脉血管阻力 (DeltaCVR) 和表心直径变化使用冠状动脉乙胆 (ACh) 测量了内皮依赖功能.
- 用酸和腺评估了内皮独立功能.
- 308名患者 (132名患有CAD,176名没有) 接受了测试,并被跟踪平均46个月.
主要成果:
- 表皮心脏和微血管内皮功能障碍 (通过ACh反应评估) 是急性心血管事件的独立预测因素.
- 包括年龄,CAD存在和体重指数在内的因素也预测了事件.
- 患有较好的微血管和心表反应的患者,无论CAD状态如何,都显示出更好的生存率.
结论:
- 心和微血管冠状动脉内皮功能障碍独立预测急性心血管事件.
- 冠状动脉血管功能测试提供了补充传统评估的预后信息.
- 这些发现强调了内皮功能在心血管风险分层中的重要性.
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