之前的乙胆刺激测试对在干预诊断程序期间冠状动脉生理评估后的影响
Tatsuro Yamazaki1, Yuichi Saito1, Daichi Yamashita1
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Journal of cardiology
|June 28, 2023
概括
没有阻塞性冠状动脉 (INOCA) 的缺血诊断测试的顺序很重要. 之前的乙胆 (ACh) 刺激可以改变随后的冠状动脉生理评估结果,特别是如果 ACh 测试是阳性的.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 诊断程序 诊断程序 诊断程序
背景情况:
- 没有阻塞性冠状动脉 (INOCA) 的缺血需要准确的诊断.
- 冠状动脉内乙胆 (ACh) 诱导和冠状动脉生理评估是INOCA的关键诊断工具.
- 这些诊断程序的最佳顺序仍在争论中.
研究的目的:
- 在冠状动脉生理评估之前,调查执行冠状动脉乙胆 (ACh) 挑测试的影响.
- 在疑似INOCA的患者中,根据ACh测试的序列和结果进行冠状动脉生理指数的比较.
主要方法:
- 120名疑似INOCA患者接受了侵入性冠状动脉生理评估.
- 根据ACh挑起是否在评估之前 (ACh组) 或没有 (没有ACh组),患者被划分为组.
- 该ACH组进一步分为阳性和阴性ACH测试结果.
主要成果:
- 与ACH组相比,没有ACH组的分流储备较低.
- 在阳性ACH组 (1.22 ± 0.55s) 中,休息平均过渡时间显着更长,其次是没有ACH (1.00 ± 0.46s) 和负ACH (0.74 ± 0.36s) 组 (p < 0.001).
- 微循环阻力指数和冠状动脉流量储备指数在各组之间没有显著差异.
结论:
- 诊断程序的顺序会影响INOCA评估中的冠状动脉生理评估结果.
- 一个积极的乙胆刺激测试显著影响后续的生理测量.
- 需要进一步的研究来确定INOCA诊断程序的最终顺序.
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