在心力衰竭中冠状动脉微循环的作用与保存的射出分数:一个不停的奥德赛
Kyriakos Dimitriadis1, Panagiotis Theofilis2, Georgios Koutsopoulos2
1First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, 11528, Athens, PO, Greece. dimitriadiskyr@yahoo.gr.
冠状动脉微血管功能障碍 (CMD) 是心力衰竭的关键因素,具有保存的喷射分数 (HFpEF). 诊断和治疗CMD可能会改善HFpEF患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 心血管研究研究心血管研究
背景情况:
- 保持喷射分数 (HFpEF) 的心力衰竭有复杂的原因.
- 冠状动脉微血管功能障碍 (CMD) 越来越多地被认为是HFpEF的重要贡献者.
- 冠状动脉疾病包括血管活性受损,毛细血管损失和炎症.
研究的目的:
- 探索冠状动脉微血管功能障碍 (CMD) 在心力衰竭中所扮演的角色.
- 审查HFpEF患者中CMD的诊断方法.
- 在HFpEF中讨论CMD的潜在治疗策略.
主要方法:
- 对CMD的非侵入性诊断技术的审查,包括心声回声学,心脏MRI和PET.
- 包括侵入性评估方法,如冠状动脉流量储备和微循环阻力指数.
- 对CMD和HFpEF预后和治疗之间的关联现有文献的分析.
主要成果:
- 在患有HFpEF的患者中经常观察到CMD.
- 既有CMD和HFpEF的存在与更糟糕的预后有关.
- 有限的证据表明,氨酸 - ангиотензин - 阿尔多斯特系统抑制剂,兰诺拉和SGLT2抑制剂对CMD有潜在的益处.
结论:
- CMD是HFpEF的关键病理生理组成部分.
- 准确诊断CMD对于管理HFpEF至关重要.
- 需要进一步的研究来建立有效的CMD药物治疗方法,包括抗炎药物.
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