在患有慢性冠状动脉综合征和中度冠状动脉狭窄症的患者中冠状动脉微循环功能障碍的患病率
Łukasz Niewiara1,2, Paweł Kleczyński1,2, Bartłomiej Guzik1,2
1Department of Interventional Cardiology, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland.
Kardiologia polska
|February 11, 2025
概括
冠状动脉微循环功能障碍 (CMD) 在患有慢性冠状动脉综合征 (CCS) 和中度冠状动脉狭窄症的患者中非常普遍. 建议进行早期的功能测试,因为患病率很高,缺乏特定的预测因素.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 冠状动脉微循环功能障碍 (CMD) 在慢性冠状动脉综合征 (CCS) 中越来越多地被认可.
- 根据目前的指导方针,关于CMD患病率的数据有限.
- 冠状动脉疾病影响诊断和CCS中的患者结果.
研究的目的:
- 为了确定中度冠状动脉血管学病变的CCS患者中CMD的患病率.
- 使用热稀释方法进行CMD评估.
主要方法:
- 101名中度冠状动脉狭窄症CCS患者的前性注册.
- 排除了显着表心狭窄症的患者.
- 评估分数流量储备,冠状动脉流量储备和微循环阻力指数 (IMR).
主要成果:
- 在45%的患者中诊断出CMD.
- 患有和没有显著缺血症的组之间,CMD患病率有显著差异 (55%与24%相比;P=0.03).
- 冠状动脉疾病组显示出较低的冠状动脉流量储备 (1.6比2.6;P<0.001) 和较高的IMR (29比15;P<0.001).
- 较高的休息全周期比率和扩张功能障碍预测了CMD.
结论:
- 在中度冠状动脉狭窄症的CCS患者中,无论狭窄症的严重程度如何,CMD的患病率很高.
- 在34%符合条件的患者中,CMD可能会导致持续性心痛.
- 由于CMD的高流行率和缺少特定预测因素,建议进行广泛的功能测试.
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