侵入性冠状动脉功能测试的现行实践和安全性:日本全国多中心调查
Takeshi Nishi1, Michikazu Nakai2, Masanobu Ishii3
1Department of Cardiovascular Medicine, Chiba University Graduate School Medicine, Chiba, Japan; Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
JACC. Advances
|January 29, 2026
概括
冠状动脉功能测试 (CFT) 是安全的和可行的诊断冠状动脉血管功能障碍,即使在紧急情况下. 这项研究支持更广泛地使用CFT治疗缺血或心肌梗塞与非阻塞性冠状动脉 (INOCA/MINOCA).
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 诊断测试 诊断测试 诊断测试
背景情况:
- 冠状动脉血管功能障碍,包括血管痛和冠状动脉微血管功能障碍,是INOCA/MINOCA的主要原因.
- 侵袭性冠状动脉功能测试 (CFT) 具有诊断价值,但其实际应用和安全性,特别是在紧急情况下,需要进一步评估.
研究的目的:
- 评估目前在日本的CFT实践,诊断产量和安全性.
- 评估乙胆 (ACh) 和人体激素 (ERG) 诱导试验,以及冠状动脉微血管评估 (CFR/IMR).
主要方法:
- 在日本235个机构进行全国性的横截面调查.
- 在2022年1月至2023年12月期间进行的CFT手术量,阳性率和并发症数据收集.
主要成果:
- 分析了超过6900个挑测试 (ACh和ERG) 和2100个CFR/IMR评估.
- 阳性率为ACH的50.9%和ERG的32.5%;严重并发症很少发生 (1.4%的ACH,0.4%的ERG).
- 异常的微血管发现在紧急情况下更频繁,并发症率较低 (0.05%).
结论:
- 侵入性CFT是可行的和安全的,包括在紧急情况下诊断INOCA/MINOCA.
- 这些发现支持在怀疑冠状动脉血管功能障碍的患者的临床实践中扩大CFT的使用.
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