ANOCA患者在运动期间绝对冠状动脉流量和微血管抵抗的变化
Michel Zeitouni1, Ghilas Rahoual1, Niki Procopi1
1Sorbonne Université, ACTION Study Group, INSERM UMRS 1166, ICAN, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France.
概括
盐水诱导的高血压是评估运动期间冠状动脉流量调节的有效方法,与运动衍生措施相对应. 这项技术有助于在患有心痛和非阻塞性冠状动脉疾病的患者中确定冠状动脉微血管功能障碍.
科学领域:
- 心脏病学 心脏病学
- 生理学 生理学 生理学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 盐水诱导的高血症能够准确地反映运动诱导的冠状动脉流量调节的能力尚不清楚.
- 在患有心痛和非阻塞性冠状动脉疾病 (ANOCA) 的患者中,评估冠状动脉微血管功能至关重要.
研究的目的:
- 在ANOCA患者中,在运动期间表征冠状动脉流量 (Q) 和微血管阻力 (Rμ) 适应.
- 调查盐水和运动衍生的冠状动脉流量储备 (CFR) 和微血管阻力储备 (MRR) 之间的相关性.
主要方法:
- 持续的热稀释评估了左前下降动脉中的Rμ,Q,CFR和MRR.
- 使用10毫升/分钟 (休息) 和20毫升/分钟 (高血) 的盐水输液.
- 运动测试涉及卧式循环与增量工作负载;盐水衍生的CFR截止值<2.5确定冠状动脉微血管功能障碍 (CMD).
主要成果:
- 冠状动脉微血管功能障碍 (CMD) 在53.3%的参与者中被确定,这些参与者使用盐水衍生的CFR.
- 与正常CFR患者相比,患有盐水定义的CMD的患者在运动期间表现出Q的大幅增加和Rμ的较小减少.
- 在盐水和运动衍生的CFR (r=0.73) 和MRR (r=0.76) 之间发现了强烈的相关性;一致性为83.3%.
结论:
- 盐水诱导的高血压是运动诱导的冠状动脉生理学的有效替代品.
- 这种技术是有效的,无论绝对CFR和MRR值.
- 运动测试为评估与运动相关的CMD患者的适应性反应提供了更详细的信息.
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