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JAHA：早期复极综合征患者冠状动脉痉挛诊断的意义！

2018-02-07 xing.T MedSci原创

早期复极综合征冠状动脉痉挛意义
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由此可见，大约40%的CAS患者在没有经历胸部症状的首次VF时存在VF和下壁J波，并且有可能被误诊为ERS。使用痉挛激发试验被认为是区分病人进行最佳治疗的必要条件。

先前描述的早期复极综合征（ERS）患者可能经历过无症状的冠状动脉痉挛（CAS），因为CAS的诊断在没有进行痉挛激发试验的情况下，主要是基于症状或冠状动脉造影的结果。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，这项研究调查了诊断CAS的意义，并评价可能为ERS（即特发性心室颤动[VF]和下壁J波）患者静默CAS的发病率。

该研究纳入了34例特发性室颤和下壁J波的患者。13例（38%）患者经冠状动脉造影诊断为CAS，其中包括经痉挛激发试验诊断的患者（n＝8）和自发性ST抬高（n＝5）患者。在13例CAS患者中，有5例（38%）患者在VF之前和发作期间没有出现胸部症状，被诊断为无症状CAS。其余21例（62%）患者，激发试验结果为阴性并且无胸部症状，被认为有ERS。

在随访的92个月里，CAS患者接受了适当的抗心绞痛药物治疗表现出良好的结果。与此相反，21例ERS患者中有4例（19%）出现VF复发。4例ERS患者经单药治疗或联合治疗，包括奎尼丁、西洛他唑和苄普地尔，能够有效地抑制VF。

由此可见，大约40%的CAS患者在没有经历胸部症状的首次VF时存在VF和下壁J波，并且有可能被误诊为ERS。使用痉挛激发试验被认为是区分病人进行最佳治疗的必要条件。

原始出处：

Tsukasa Kamakura,et al. Significance of Coronary Artery Spasm Diagnosis in Patients With Early Repolarization Syndrome.JAHA.2018. https://doi.org/10.1161/JAHA.117.007942

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    2018-02-09 zhaohui6731

    #AHA#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1267717, encodeId=96ce126e71769, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311755, encodeId=0e651311e55d4, content=<a href='/topic/show?id=624de11204a' target=_blank style='color:#2F92EE;'>#痉挛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71120, encryptionId=624de11204a, topicName=痉挛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431110, encodeId=b4b3143111019, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=286046, encodeId=f8322860468c, content=不错的文章.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed Feb 07 22:41:09 CST 2018, time=2018-02-07, status=1, ipAttribution=)]
    2018-02-09 apoenzyme

    #痉挛#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1267717, encodeId=96ce126e71769, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311755, encodeId=0e651311e55d4, content=<a href='/topic/show?id=624de11204a' target=_blank style='color:#2F92EE;'>#痉挛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71120, encryptionId=624de11204a, topicName=痉挛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431110, encodeId=b4b3143111019, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=286046, encodeId=f8322860468c, content=不错的文章.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed Feb 07 22:41:09 CST 2018, time=2018-02-07, status=1, ipAttribution=)]
    2018-02-09 zhouqu_8

    #综合征#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1267717, encodeId=96ce126e71769, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311755, encodeId=0e651311e55d4, content=<a href='/topic/show?id=624de11204a' target=_blank style='color:#2F92EE;'>#痉挛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71120, encryptionId=624de11204a, topicName=痉挛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431110, encodeId=b4b3143111019, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Feb 09 12:34:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=286046, encodeId=f8322860468c, content=不错的文章.值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed Feb 07 22:41:09 CST 2018, time=2018-02-07, status=1, ipAttribution=)]
    2018-02-07 131****2916

    不错的文章.值得推荐

    0