国际专家工作组算法的比较,用于诊断非阻塞性冠状动脉的心痛
Christopher C Y Wong1, Vedant S Pargaonkar2, Luke P Dawson2
1Division of Cardiovascular Medicine, Stanford University School of Medicine and Stanford Cardiovascular Institute, Stanford, California, USA; Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
JACC. Cardiovascular interventions
|December 24, 2025
概括
微血管网络 (MVN) 算法为非阻塞性冠状动脉 (ANOCA) 末型的胸痛提供了比欧洲皮肤性心血管干预协会 (EAPCI) 算法更高的诊断产量. 在怀疑ANOCA时,建议对心肌桥梁和内皮功能障碍进行测试.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 内部医学 内部医学
背景情况:
- 冠状动脉功能测试 (CFT) 对非阻塞性冠状动脉 (ANOCA) 的心痛的协议在各专家组之间有所不同.
- 欧洲皮肤心血管干预协会 (EAPCI) 专注于和微血管功能障碍.
- 微血管网络 (MVN) 包括心肌桥梁和内皮功能障碍评估.
研究的目的:
- 在ANOCA患者中比较EAPCI和MVN算法的诊断产量.
- 评估ANOCA的不同诊断策略的有效性.
主要方法:
- 使用了分数流量储备,冠状动脉流量储备,微循环阻力指数,血管内超声波和乙胆刺激.
- 在疑似ANOCA的患者中评估心肌桥梁.
主要成果:
- 在88.2%的患者中,MVN算法识别了ANOCA,而EAPCI (P < 0.001) 则为53.5%.
- MVN将EAPCI66.7%的非心脏性胸痛患者和84.3%的EAPCI阻塞性冠状动脉疾病患者重新分类为ANOCA内型.
- 通过MVN对心脏胸痛进行分类的患者在西雅图Angina问卷中得分明显较低.
结论:
- 与EAPCI算法相比,MVN算法显示了ANOCA内型的优异诊断产量.
- 在疑似ANOCA病例中,建议对心肌桥梁和内皮功能障碍进行例行评估.
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