冠状动脉微血管功能障碍的预后值在患有大动脉狭窄和冠状动脉不阻塞的患者中
Ayman A Mohammed1,2, Hengbin Zhang1, Siqi Li1
1Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China.
Journal of cardiovascular medicine (Hagerstown, Md.)
|November 9, 2023
概括
冠状动脉微血管功能障碍 (CMD) 在大动脉狭窄患者中很常见,并预测不良心血管事件. 冠状动脉血管学衍生的微循环阻力指数 (caIMR) 有效地评估CMD并识别高风险个体.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 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) 与大动脉狭窄症 (AVS) 的症状和结果有关.
- 冠状动脉血管学 (CAG) 衍生微循环阻力指数 (caIMR) 提供了一种新的,无压力无线的方法来评估CMD.
研究的目的:
- 在AVS患者中使用caIMR量化CMD.
- 评估caIMR评估的CMD在预测主要心血管不良事件 (MACE) 的预后意义.
主要方法:
- 77名中度或重度AVS且没有阻塞性冠状动脉疾病的患者接受了caIMR测量.
- 定义为CMD的caIMR≥25,MACE被追踪了40个月的中位数.
主要成果:
- 冠状动脉疾病的发病率为47.7%,记录了17个MACE.
- 冠状动脉疾病与MACE风险增加显著相关 (P < 0.001),并且是一个独立的预测因子 (HR 5.467,P = 0.015).
- caIMR显示了MACE的显著预测值 (AUC 0.785,P < 0.001),特别是在严重的AVS和非AVR患者中.
结论:
- 患有AVS的患者表现出显著的caIMR损伤.
- 根据caIMR的评估,CMD是AVS患者不良结果的独立预测因素.
- caIMR可能有助于识别高风险AVS患者,以便更早地进行干预.
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