JACC:冠脉微血管功能障碍的生理变化研究

2020-05-24 MedSci原创 MedSci原创

冠状动脉微血管功能障碍(CMD)的定义是血流储备的减少,本研究的目的旨在评估CMD内质型静息和最大血流改变的机制。

冠状动脉微血管功能障碍(CMD)的定义是血流储备的减少,本研究的目的旨在评估CMD内质型静息和最大血流改变的机制。

本研究纳入分析了86名心绞痛但不伴有冠脉梗阻的患者,并在在休息、运动和腺苷介导的充血期间接受冠状动脉压力和流量测量,其中有46名患者被诊断为CMD(28名为功能性CMD,18名为结构性CMD),另外40名作为对照组。与对照组和结构性CMD相比,功能性CMD患者的静息冠脉血流(CBF)和一氧化氮合酶(NOS)活性要更高。结构性CMD患者的乙酰胆碱前臂血流量(FBF)增强要低于对照组和功能性CMD患者。另外,在运动后,氧需求在结构性CMD患者中是最高的,但是峰值CBF却是最低的。

研究结果显示,功能性冠脉微血管功能障碍的特征是静息血流升高,NOS活性增强,而结构性CMD患者的内皮功能障碍,从而导致运动后氧需求增高而峰值前臂血流量降低。

原始出处:

Haseeb R et al.Physiological Stratification of Patients With Angina Due to Coronary Microvascular Dysfunction.JACC.2020 May.

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    2020-06-13 仁者大医
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    2020-05-26 mgqwxj
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