冠状动脉微血管功能障碍和心力衰竭与保存的喷射分数:有什么机械联系?
Aish Sinha1, Haseeb Rahman, Divaka Perera
1British Heart Foundation Centre of Excellence and National Institute for Health Research, Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, London, UK.
Current opinion in cardiology
|September 5, 2023
概括
冠状动脉微血管功能障碍 (CMD) 是常见的心力衰竭与保存的喷射分数 (HFpEF). 了解CMD和HFpEF之间的联系可能会导致这种疾病的更好的治疗方法.
科学领域:
- 心脏病学 心脏病学
- 心血管研究研究心血管研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是一个重大的临床挑战,占所有预后不佳的心力衰竭病例的一半.
- HFpEF是异质的,包括各种病理生理条件.
- 冠状动脉微血管功能障碍 (CMD),以冠状动脉血流增加不足而没有表心病为特征,是HFpEF人口中普遍存在的疾病.
研究的目的:
- 审查最近研究CMD和HFpEF之间的关联的研究.
- 阐明将CMD和HFpEF联系在一起的病理生理机制.
- 突出了解CMD-HFpEF内型的临床相关性,以开发向疗法.
主要方法:
- 评论最近的科学文献.
- 分析表明CMD和HFpEF之间的关联的研究.
- 检查病理生理学联系和临床结果.
主要成果:
- 在HFpEF患者中,CMD非常普遍,通过侵入性或非侵入性方法诊断.
- 在HFpEF患者中心肌输液储备 (MPR) 损伤与更差的结局相关.
- MPR和冠状动脉流量储备 (CFR) 都与左心室透静功能和填充压力有关,与受损的光和下内心缺血症有机械连接CMD和HFpEF.
结论:
- 冠状动脉微血管功能障碍-心力衰竭与保存的喷射分数 (CMD-HFpEF) 是一个与不良的心血管预后相关的显著内型.
- 目前尚不清楚CMD和HFpEF之间的因果关系 (CMD是否导致HFpEF或反之).
- 需要进一步的研究才能充分理解CMD-HFpEF的机制联系,并指导治疗策略.
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