微血管血管运动功能障碍在女性中更为普遍,而在男性ANOCA患者中,表心血管功能障碍更为普遍
J Woudstra1, A C Dimitriu-Leen2, C Crooijmans2
1Amsterdam UMC Heart Centre, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
International journal of cardiology
|February 8, 2026
概括
冠状动脉血管功能障碍在亚型中显示出性别差异,男性经历更多的表心,女性经历更多的微血管. 功能性微血管功能障碍在所有年龄段的女性中更为常见.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 冠状动脉血管功能障碍是慢性冠状动脉综合征的关键因素,但性别和年龄特异性差异仍未得到充分研究.
- 荷兰国家冠状动脉功能测试 (NL-CFT) 注册表提供了一个平台来调查这些知识差距.
研究的目的:
- 评估冠状动脉血管功能障碍内型的性别和年龄特异性.
- 分析心上,微血管和微血管血管扩张能力降低的患有非阻塞性冠状动脉 (ANOCA) 患者的痛的患病率.
主要方法:
- 分析了1008名ANOCA患者 (83%为女性,平均年龄为60岁) 在2020-2024年期间接受冠状动脉功能测试 (CFT).
- CFT包括血管刺激和微血管功能评估 (冠状动脉流量储备和微血管抵抗).
- 患者分为年轻 (≤54),中等 (≥54至<67) 和老年 (≥67) 的年龄组.
主要成果:
- 总体上,冠状动脉血管功能障碍的患病率很高 (76%),性别差异相似.
- 副心在男性 (年轻/中等组) 中更常见,而微血管在女性 (年轻/中等组) 中更为普遍.
- 功能性降低的微血管血管扩张能力在女性中更为普遍,而结构性损伤在不同性别和年龄之间是相似的.
结论:
- 在ANOCA患者中,冠状动脉血管功能障碍的内型存在显著的基于性别的差异.
- 男性更容易患上心上,而女性患微血管的比例更高.
- 功能性微血管损伤是女性的主要问题,不论年龄.
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