超越阻塞性范式:揭示非阻塞性冠状动脉疾病的复杂景观
Andreea Tudurachi1, Larisa Anghel1,2, Bogdan-Sorin Tudurachi1,2
1Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I. M. Georgescu", 700503 Iași, Romania.
非阻塞性冠状动脉疾病 (CAD) 是常见的在患有胸痛的患者. 这一综述强调了对这种未被认可的疾病的新诊断和治疗策略的需要.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 阻塞性动脉样硬化在历史上主导了心脏研究.
- 高达70%的心痛患者在血管造影上没有显著的冠状动脉狭窄.
- 非阻塞性冠状动脉疾病 (CAD) 是一个普遍的临床表型.
研究的目的:
- 审查非阻塞性CAD的流行率和病理生理学.
- 突出目前阻塞性CAD治疗方法的局限性.
- 倡导对非阻塞性CAD进行修订的诊断和治疗方法.
主要方法:
- 关于非阻塞性CAD的当前文献的综述.
- 专注于诸如无阻塞性冠状动脉疾病 (ANOCA) 的胸痛,无阻塞性冠状动脉疾病 (INOCA) 的缺血,无阻塞性冠状动脉疾病 (MINOCA) 的心肌梗塞等疾病.
- 分析病理生理学,包括微血管功能障碍和冠状动脉血管活性.
主要成果:
- 非阻塞性CAD是心脏病患者中最常见的表型.
- 微血管功能障碍和冠状动脉血管活性受损是导致缺血的关键因素.
- 目前的治疗方法往往不足,因为它们针对阻塞性病变.
结论:
- 诊断和管理非阻塞性CAD的范式转变是必要的.
- 需要针对微血管和免疫炎症通路的量身定制疗法.
- 改善这种流行病患者子组的识别和管理是至关重要的.
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