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胸部疼痛心肌粉症:发生,原因和预后意义
Laura De Michieli1, Monica De Gaspari2, Giulio Sinigiani1
1Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy.
International journal of cardiology
|July 22, 2023
概括
胸痛在心肌粉症 (CA) 中很常见,表明疾病已晚,并预测心力衰竭住院治疗. 病因因因CA类型而异,ATTR-CA中阻塞性冠状动脉疾病 (CAD),AL-CA中粉样蛋白参与.
科学领域:
- 心脏病学 心脏病学
- 心血管疾病 心血管疾病
- 氨基粉症是什么 氨基粉症是什么
背景情况:
- 胸部疼痛是心脏粉症 (CA) 的已知症状之一.
- 缺乏对胸痛频率,原因和CA中意义的系统调查.
研究的目的:
- 调查心脏粉症患者胸痛的频率,病因和临床意义.
- 为了区分胸痛的原因,我们将跨氨酸氨基粉症 (ATTR-CA) 和轻链氨基粉症 (AL-CA) 分开.
主要方法:
- 从174名CA患者 (104名ATTR-CA,70名AL-CA) 的临床,心声学,实验室,冠状动脉成像和内心肌活检 (EMB) 数据分析.
- 胸痛和没有胸痛的CA患者之间的特征比较.
- 评价胸痛作为心力衰竭住院预测因素.
主要成果:
- 在38%的CA患者中报告了胸痛.
- 患有胸痛的患者有较高的冠状动脉疾病 (CAD) 史,心力衰竭 (HF) 症状和心脏生物标志物 (hs-cTnI, BNP) 的比率.
- 在胸痛的ATTR-CA患者中,阻塞性CAD更为频繁 (53%vs0%在AL-CA中),而血管/周血管粉样蛋白沉积在AL-CA患者中更为常见 (80%vs20%在ATTR-CA中).
- 在随访期间,胸痛预测未来的HF住院治疗.
结论:
- 胸痛是CA的常见症状,反映了晚期心脏功能障碍.
- 在CA的胸痛预测未来的心力衰竭住院治疗.
- 在CA的胸痛的根本原因在ATTR-CA和AL-CA亚型之间有所不同.
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