性别对冠状动脉微血管功能障碍和心脏结果的影响
Venkatesh L Murthy1, Masanao Naya1, Viviany R Taqueti1
1From the Division of Cardiovascular Medicine, Department of Internal Medicine, and Divisions of Nuclear Medicine and Cardiothoracic Imaging, Department of Radiology, University of Michigan, Ann Arbor, MI (V.L.M.); Noninvasive Cardiovascular Imaging Program, Departments of Internal Medicine and Radiology (V.L.M., M.N., V.R.T., S.D., R.B., M.F.D.C.), and Division of Cardiovascular Medicine, Department of Medicine (V.L.M., V.R.T., J.H., S.D., R.B., M.F.D.C.), Brigham & Women's Hospital, Boston, MA; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (C.R.F., M.G., J.H., S.D., M.F.D.C.), and Istituto di Bioimmagini e Fisiologia Molecolare (O.R.), Consiglio Nazionale delle Ricerche and Scientific Institute San Raffaele, Milan, Italy; Division of Cardiology, Vita Salute University and Scientific Institute San Raffaele, Milan, Italy (P.G.C.).
冠状动脉微血管功能障碍 (CMD) 影响男性和女性均等,并预测不良心脏事件. 这一发现表明,CMD是两性治疗的关键标.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 冠状动脉微血管功能障碍 (CMD) 在疑似冠状动脉疾病 (CAD) 的患者中很常见.
- 男人与女性中CMD的患病率尚不清楚.
- 在患有CAD症状的患者中,CMD与预后不佳有关.
研究的目的:
- 确定怀疑CAD的男性和女性中CMD的患病率.
- 评估CMD和主要不良心脏事件 (MACE) 之间的关联,不论性别.
- 评估冠状动脉流量储备 (CFR) 作为MACE的预测指标.
主要方法:
- pozitron发射断层扫描和心肌输液成像用于评估405名男性和813名女性的CFR.
- 在CMD的定义中,CFR<2.0是CMD的定义.
- 主要不良心脏事件的中位数是1.3年.
主要成果:
- 在男性 (51%) 和女性 (54%) 中,CMD的流行率很高.
- 较低的CFR是MACE的显著预测指标 (HR 0.80每10%的增加;P<0.0001).
- 冠状动脉疾病甚至在没有冠状动脉化或异常压力输液的患者中也很普遍.
结论:
- 在怀疑CAD的男性和女性中,CMD的流行率很高.
- 冠状动脉疾病是两个性别不良心血管结果的独立预测因素.
- 准CMD可能会改善广泛患者群体的治疗结果.
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