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大动脉与远程压力对比,用于推导高血压微血管抵抗:来自LIAS注册表

Hanae F Namba¹, Coen K M Boerhout¹, Elize A M de Jong²

¹Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands.

International journal of cardiology

|October 11, 2024

概括

在患有非阻塞性冠状动脉 (ANOCA) 和FFR>0.80.0.的胸痛患者中,使用大动脉压力 (Pa) 可以准确测量高血压的微血管抵抗 (HMR). 然而,当FFR小于0.80.80时,出现了显著的差异.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
血管生理学血管生理学

背景情况:

患有心痛和非阻塞性冠状动脉 (ANOCA) 的患者通常会接受冠状动脉功能测试.
在最大高血压期间,使用冠状动脉流量和远程压力 (Pd) 评估最小的微血管阻力.
大动脉压力 (Pa) 可能是Pd的可行的替代方案,用于在ANOCA中获得高血压微血管抵抗力 (HMR),但这仍然没有研究.

研究的目的:

调查使用大动脉压力 (Pa) 而不是远程压力 (Pd) 计算高血压微血管阻力 (HMR) 在ANOCA患者的可行性.
为了比较来自Pa与Pd的大型患者队列中的HMR值.

主要方法:

使用了来自ILIAS注册表的数据,这是冠状动脉压力和流量数据的全球多中心注册表.
包括1321个被评估的血管,来自患有稳定的胸痛症状的患者.
使用Pa与Pd计算的HMR比较,使用Pearson系数和Bland-Altman图分析相关性和一致性.

主要成果:

使用Pa和Pd计算的HMR之间发现了良好的整体相关性 (皮尔森r=0.84,p≤0.005).
布兰德-阿尔特曼分析显示,平均差异为0.53 (±1.35达成一致的极限).
在HMR测量中的差异与表皮心病变严重程度 (FFR) 有显著的关系,在FFR<0.80.0的患者中异常值增加.

结论:

在FFR>0.80的ANOCA患者中,HMR可以使用大动脉压力 (Pa) 而不是距离压力 (Pd) 准确测量.
在FFR<0.80.0的患者中,Pa和Pd测量的HMR存在显著差异.
在特定的ANOCA患者亚组中,大动脉压力可以作为HMR评估的更简单的替代方案.

关键词:

亚诺卡亚亚诺卡亚是什么意思冠状动脉微血管功能障碍冠状动脉微血管功能障碍过度高血压的微血管耐药性

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