当代临床实践中的冠状动脉微血管疾病
Nathaniel R Smilowitz1,2, Olga Toleva3, Alaide Chieffo4
1Division of Cardiology, Department of Medicine, NYU Langone Health, NY (N.R.S.).
Circulation. Cardiovascular interventions
|June 1, 2023
概括
建议对患有非阻塞性冠状动脉疾病的患者进行冠状动脉微血管疾病 (CMD) 测试. 综合诊断方法可以改善患者的治疗结果,并指导缺血性心脏病的向治疗.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 诊断测试 诊断测试 诊断测试
背景情况:
- 冠状动脉微血管疾病 (CMD) 是心肌缺血的重要原因在不同的临床环境.
- 临床指南建议在患有缺血和非阻塞性冠状动脉疾病的患者进行常规CMD检测.
- 准确诊断CMD对于有效的患者管理至关重要.
研究的目的:
- 概述冠状动脉微血管疾病 (CMD) 的诊断方法.
- 强调CMD综合测试在改善以患者为中心的治疗结果方面所带来的好处.
- 探索CMD测试在各种心血管疾病中的潜在作用,除了非阻塞性冠状动脉疾病的缺血之外.
主要方法:
- 侵入性诊断方法包括多普勒或热稀释以评估冠状动脉流量储备和微血管阻力.
- 乙胆冠状动脉反应性测试用于检测内皮功能障碍和冠状动脉.
- 综合性测试整合了多种模式,以确定最终的CMD诊断.
主要成果:
- 综合性CMD测试可以改善患者的症状,提高生活质量,增加患者的满意度.
- 确立诊断指导了针对性的医疗疗法和生活方式改变的实施.
- 在急性心肌梗塞,重血管化后心痛,心力衰竭与保存的喷射分数,塔科茨乌博综合征和心脏移植后的病例中,CMD测试可能是有益的.
结论:
- 冠状动脉微血管疾病 (CMD) 的常规侵入性和功能测试得到了临床指南的支持.
- 对CMD进行全面的诊断策略对于优化治疗和改善患者的治疗结果至关重要.
- 提高医疗保健提供者对CMD的认识和教育是必要的,以提高缺血性心脏病患者的护理.
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