促使冠状动脉微血管功能障碍的因素在患有心痛和非阻塞性冠状动脉疾病的患者中
Hiroki Teragawa1, Yuko Uchimura1, Chikage Oshita1
1Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36, Futabanosato, Higashi-Ku, Hiroshima 732-0057, Japan.
Journal of cardiovascular development and disease
|July 26, 2024
概括
吸烟和使用厄戈诺文酸 (EM) 与冠状动脉微血管功能障碍 (CMD) 有关. 根据性别,CMD的风险因素有所不同,这凸显了戒烟的重要性以及在使用EM时仔细评估.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 冠状动脉微血管功能障碍 (CMD) 是胸痛的重要原因,但其风险和有效的治疗方法尚不清楚.
- 虽然心力衰竭和冠状动脉疾病 (CAD) 是已知的危险因素,特别是在女性中,但其他促成因素需要调查.
- 这项研究侧重于心痛和非阻塞性冠状动脉疾病 (ANOCA) 的患者,不包括心力衰竭或显著冠状动脉狭窄症患者.
研究的目的:
- 在ANOCA患者中评估CMD的风险因素.
- 调查CMD的风险是否根据特定的促成因素和性别而有所不同.
主要方法:
- 84名ANOCA患者接受了冠状动脉血管学和功能测试,包括用乙胆 (ACh) 和勃胺酸 (EM) 进行刺激测试 (SPT),以及冠状动脉微血管功能测试 (CMVF).
- 冠状动脉微血管功能通过测量冠状动脉流量储备 (CFR) 和微循环阻力指数 (IMR) 来评估. 在CMD的定义中,CFR<2.0或IMR≥25.
- 进行了后勤回归分析,以确定实验室指数和CMD组件之间的相关性.
主要成果:
- 在55%的患者中发现了CMD,与吸烟和EM使用相关.
- 与降低CFR相关的因素包括心声回声仪指数E/e',而RAS抑制剂使用和吸烟与IMR增加相关.
- 性别分析显示,吸烟是男性的CMD风险因素,女性的左心室质量指数和低糖化血红蛋白.
结论:
- 吸烟状态和EM使用与CMD有关,性别和CMD组件之间的风险概况不同.
- 戒烟对于管理CMD至关重要.
- 建议在使用EM后ACh挑时进行仔细的CMD评估,在更大的研究中需要进一步验证.
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