冠状动脉鼻腔减动器改善心痛,生活质量和冠状动脉流量储备在微血管功能障碍
David Tryon1, Michel T Corban2, Mohamad Alkhouli1
1Mayo Clinic, Rochester, Minnesota, USA.
JACC. Cardiovascular interventions
|November 9, 2024
概括
冠状动脉鼻 (CS) 减缓剂改善了冠状动脉微血管功能障碍 (CMD) 患者的胸痛,生活质量和冠状动脉微血管功能. 这种设备可能为无阻塞性冠状动脉疾病 (ANOCA) 的心痛提供一种新的治疗方法.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 干预心脏病学 干预心脏病学
背景情况:
- 冠状动脉微血管功能障碍 (CMD) 是无阻塞性冠状动脉疾病 (ANOCA) 的胸痛的主要原因.
- 对于患有CMD和ANOCA的患者,有效的治疗选择有限.
研究的目的:
- 评估冠状动脉鼻 (CS) 减小剂在诊断为CMD的患者中治疗心痛的安全性和有效性.
- 评估CS Reducer对冠状动脉微血管功能的影响以及患者报告的结果.
主要方法:
- 一项II期试验涉及30名患者,尽管接受了医疗治疗,但患有ANOCA和CCS等级3-4的胸痛.
- 冠状动脉微血管功能测试 (冠状动脉流量储备和乙胆反应) 在植入CS Reducer之前和120天后.
- 主要终点:微血管功能的变化;次要终点:心痛类和生活质量的变化 (SAQ分数).
主要成果:
- 冠状动脉流量储备 (CFR) 的显著改善在内皮独立的CMD患者中 (P=0.0011).
- 在依赖内皮的CMD患者中对乙胆增强冠状动脉血流反应 (P=0.042).
- 在加拿大心血管学会 (CCS) 胸痛类别 (P<0.001) 中显著减少,在西雅图胸痛问卷 (SAQ) 得分中得到改善 (P<0.006).
结论:
- 在CMD患者中,CS Reducer显著改善了心肌痛症状,生活质量和冠状动脉微血管功能.
- 该CS Reducer显示出作为ANOCA患者的新疗法选择的潜力.
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