动态微血管功能障碍在缺血和没有阻塞性冠状动脉疾病患者的非侵入性评估,怀疑血管
Ana Djordjevic Dikic1,2, Srdjan Dedic2, Ivana Jovanovic1,2
1University of Belgrade Faculty of Medicine, Serbia, Belgrade.
Journal of cardiovascular medicine (Hagerstown, Md.)
|December 8, 2023
概括
在INOCA患者中,动态冠状动脉微血管功能障碍可以通过非侵入性评估. 压力心电回声学与高通风和运动在检测缺血方面比单独的高通风更有效.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 身体生理学 身体生理学
背景情况:
- 缺血和没有阻塞性冠状动脉疾病 (INOCA) 通常涉及动态冠状动脉微血管功能障碍 (CMD).
- 在INOCA患者中对动态CMD的非侵入性评估具有挑战性.
研究的目的:
- 为了评估INOCA患者的动态心血管疾病,使用压力心声学.
- 为了比较不同刺激 (高通风,运动) 在诱导缺血的有效性.
主要方法:
- 对40名INOCA患者进行的前性单中心研究.
- 应力回声心脏图与评估区域壁运动异常 (RWMA) 和冠状动脉流速 (CFV) 在LAD动脉.
- 刺激包括高通风 (HYP),HYP+卧式自行车运动 (HYP+EXE) 和腺 (ADO).
主要成果:
- 在52%的患者中,高通风 (HYP) 诱导了矛盾的CFV减少.
- 在诱导胸痛,ST变化和RWMA方面,HYP+EXE比单独的HYP更有效.
- 所有患者都保留了腺素诱导的血管扩张,这表明没有结构性CMD.
结论:
- 在INOCA患者没有结构性CMD时,HYP后冠状动脉血管收缩是常见的.
- HYP+EXE压力测试是一种强大的非侵入性方法,用于诱导缺血症.
- 使用LAD-CFV评估的压力心声学可以评估压力期间的动态和结构性冠状动脉微循环.
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