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冠状动脉微血管功能障碍和血管静脉炎-病理生理学,诊断和管理策略

Joanna Abramik^1,2, Mark Mariathas¹, Ioannis Felekos¹

¹Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Terrell Street, Bristol BS2 8ED, UK.

Journal of clinical medicine

|February 26, 2025

概括

冠状动脉微血管功能障碍 (CMD) 和血管节炎 (VSA) 显著增加主要心血管不良事件的风险. 本综述涵盖了CMD和VSA的诊断方法和治疗方法,突出了研究缺口.

科学领域:

心脏病学心脏病学
血管生物学血管生物学
公共卫生公共卫生

背景情况:

冠状动脉疾病 (CAD) 造成了全球严重的死亡率和经济负担.
传统的CAD侧重于表心动脉样硬化,忽视了冠状动脉微血管的关键作用.
冠状动脉微血管功能障碍 (CMD) 和血管痛 (VSA) 越来越多地被认为是导致不良心血管事件的主要原因,即使心上动脉没有阻塞.

研究的目的:

审查目前的诊断方法 (侵入性和非侵入性) 对CMD和VSA.
评估支持CMD和VSA现有和新型治疗策略的证据.
确定关键的研究差距,并建议未来的方向,以改善理解和管理.

主要方法:

对CMD和VSA的侵入性和非侵入性诊断技术的文献综述.
对当前药物,生活方式和非药物治疗方法的证据分析.
通过对现有研究的批判性评估,识别研究缺口.

主要成果:

患有CMD和VSA的患者面临重大心血管不良事件 (MACE) 的风险增加,包括死亡.
目前对CMD和VSA的诊断策略正在发展,对最佳方法的研究正在进行中.
证据支持内型特异性药理疗法,生活方式修改和新兴的非药理疗法.

结论:

冠状动脉疾病和静脉动脉系统疾病是关键的疾病,需要专注的注意力,而不仅仅是上心脏疾病.
提高诊断准确度和量身定制的治疗策略对于管理CMD和VSA患者至关重要.
需要进一步的研究来解决知识差距,并优化CMD和VSA患者的治疗结果.

关键词:

冠状动脉微血管功能障碍冠状动脉鼻减小剂冠状动脉鼻减小剂侵袭性冠状动脉功能检测试验个性化医疗治疗是个性化的医疗治疗.血管动性心痛 (Vasospastic Angina) 是一种心痛.

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