冠状动脉评估的收益率在持续的单形心室动脉高心率中
Ashwin Bhaskaran1, Kasun De Silva2, Samual Turnbull3
1Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Applied Research Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: https://www.twitter.com/drashwinb.
在持续的单形心室性心力衰竭 (SMVT) 中冠状动脉评估的效用有限,因为急性冠状动脉封闭是罕见的. 仅靠血管再循环并不能防止静脉瘤复发,这表明需要全面的治疗策略.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 干预心脏病学 干预心脏病学
背景情况:
- 冠状动脉疾病 (CAD) 的评估在持续的单形心室性心力衰竭 (SMVT) 患者中很常见.
- 在SMVT中冠状动脉评估的诊断产量和治疗影响还不清楚.
研究的目的:
- 为了确定SMVT患者的CAD患病率.
- 为了确定影响冠状动脉评估转诊的因素.
- 评估基于CAD管理的临床结果 (再血管化与医学治疗).
主要方法:
- 在2017-2022年期间入院的249名连续SMVT患者的回顾性分析.
- 在140名患者中进行了冠状动脉评估.
- 在重新血管化的和医疗管理的CAD患者之间比较结果.
主要成果:
- 在34%的评估患者中发现了显著的CAD;没有发现急性冠状动脉封闭.
- 胸痛和升高的激素水平影响了转诊,但没有预测显著的CAD.
- 在19名患者的复血管化 (PCI或CABG) 与医疗管理相比,并没有显著减少静脉瘤复发.
- 一个仅进行再血管化的策略显示,静脉瘤复发率很高.
结论:
- 在SMVT患者中冠状动脉评估具有适度的收益率,缺少急性冠状动脉封闭.
- 传统的缺血指标不能提高冠状动脉评估的产量.
- 仅仅进行血管再循环是不足以防止SMVT患者的静脉瘤复发.
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