超声心动图评价冠状动脉慢血流现象的研究进展
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摘要
冠状动脉慢血流现象(CSFP)指通过冠状动脉造影发现冠状动脉末梢灌注延迟,但无明显的冠状动脉病变。多数患者并无心脏结构及收缩功能异常,但可能出现胸痛症状反复发作,严重影响患者的生活质量。因此,以简便、无创、安全的检查手段确诊并评估CSFP尤为重要。随着近年超声心动图的发展,通过常规超声、二维及三维斑点追踪成像及心肌CEUS等多种超声技术均可对CSFP进行定性、定量分析。本文对超声心动图评价CSFP的研究进展进行综述。
Coronary slow flow phenomenon(CSFP)is an angiographic diagnosis characterized by delayed peripheral coronary perfusion in the absence of significant epicardial coronary lesions.Cardiac structure and systolic function of most patients had no abnormality,but there might be recurrent chest pain with impairment in quality of life.Therefore,it is very important to diagnose and assess CSFP using noninvasive,easy and safe technique.With the development of echocardiography in recent years,CSPF can be quantitatively and qualitatively analyzed with conventional echocardiography,two-dimensional and three-dimensional speckle tracking echocardiography and myocardial contrast echocardiography.Progresses of echocardiography in evaluating CSFP were reviewed in this article.
Coronary slow flow phenomenon(CSFP)is an angiographic diagnosis characterized by delayed peripheral coronary perfusion in the absence of significant epicardial coronary lesions.Cardiac structure and systolic function of most patients had no abnormality,but there might be recurrent chest pain with impairment in quality of life.Therefore,it is very important to diagnose and assess CSFP using noninvasive,easy and safe technique.With the development of echocardiography in recent years,CSPF can be quantitatively and qualitatively analyzed with conventional echocardiography,two-dimensional and three-dimensional speckle tracking echocardiography and myocardial contrast echocardiography.Progresses of echocardiography in evaluating CSFP were reviewed in this article.
引文
[1]Beltrame JF,Limaye SB,Horowitz JD.The coronary slow flow phenomenon—a new coronary microvascular disorder.Cardiology,2002,97(4):197-202.
[2]Hawkins BM,Stavrakis S,Rousan TA,et al.Coronary slow flow—prevalence and clinical correlations.Circ J,2012,76(4):936-942.
[3]Mangieri E,Macchiarelli G,Ciavolella M,et al.Slow coronary flow:Clinical and histopathological features inpatients with otherwise normal epicardial coronary arteries.Cathet Cardiovasc Diagn,1996,37(4):375-381.
[4]Yilmaz H,Demir I,Uyar Z.Clinical and coronary angiographic characteristics of patients with coronary slow flow.Acta Cardiol,2008,63(5):579-584.
[5]李阳,马春燕,刘爽,等.二维斑点追踪成像技术评价左心室不同部位心肌梗死患者右心室心肌功能.中国医学影像技术,2016,32(7):1047-1051.
[6]Tambe AA,Demany MA,Zimmerman HA,et al.Angina pectoris and slow flow velocity of dye in coronary arteries:A new angiographic finding.Am Heart J,1972,84(1):66-71.
[7]Li JJ,Xu B,Li ZC,et al.Is slow coronary flow associated with inflammation?Med Hypotheses,2006,66(3):504-508.
[8]Cin VG,Pekdemir H,Camsar A,et al.Diffuse intimal thickening of coronary arteries in slow coronary flow.Jpn Heart J,2003,44(6):907-919.
[9]Wang X,Geng LL,Nie SP.Coronary slow flow phenomenon:A local or systemic disease?Med Hypotheses,2010,75(3):334-337.
[10]Pekdemir H,Polat G,Cin VG,et al.Elevated plasma endothelin-1levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow.Int J Cardiol,2004,97(1):35-41.
[11]Beltrame JF,Limaye SB,Wuttke RD.Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon.Am Heart J,2003,146(1):84-90.
[12]Madak N,Nazli Y,Mergen H,et al.Acute phase reactants in patients with coronary slow flow phenomenon.Anadolu Kardiyol Derg,2010,10(5):416-420.
[13]Gokce M,Kaplan S,Tekelioglu Y,et al.Platelet function disorder in patients with coronary slow flow.Clin Cardiol,2005,28(3):145-148.
[14]Camsarl A,Pekdemir H,Cicek D,et al.Endothelin-1and nitric oxide concentrations and their response to exercise in patients with slow coronary flow.Circ J,2003,67(12):1022-1028.
[15]Yildiz A,Gur M,Yilmaz R,et al.Association of paraoxonase activity and coronary blood flow.Atherosclerosis,2008,197(1):257-263.
[16]Enli Y,Türk M,Akbay R,et al.Oxidative stress parameters in patients with slow coronary flow.Adv Ther,2008,25(1):37-44.
[17]Buchthal SD,den Hollander JA,Bairey Merz N,et al.Abnormal myocardial phosphorus-31nuclear magnetic resonance spectroscopy in women with chest pain but normal coronary angiograms.New Eng J Med,2000,342(12):829-835.
[18]Merih B,Emre Cumhur B,Salih T,et al.Assessment of left ventricular function and Tei index by tissue Doppler imaging in patients with slow coronary flow.Wiley J,2009,26(10):1167-1172.
[19]Elsherbiny IA.Left ventricular function and exercise capacity in patientswith slow coronary flow.Echocardiography,2012,29(2):158-164.
[20]Sevimli S,Büyükkaya E,Gündogdu F,et al.Left ventricular function inpatients with coronary slow flow:A tissue Doppler study.Turk Kardiyol Dern Ars,2007,35(5):360-365.
[21]Sezgin AT,Topal E,Barutcu I,et al.Impaired left ventricle filling in slow coronary flow phenomenon:An echo-Doppler Study.Angiology,2005,56(4):397-401.
[22]Fatih A,Fatih K,Koksal C,et al.The Effect of slow coronary flow on right and left ventricular performance.Med Princ Pract,2014,23(1):34-39.
[23]Yilmaz M,Ozluk F,Peker T,et al.Right ventricular function and its relation with TIMI frame count in the coronary slow flow phenomenon.Turk J Med Sci,2013,43(1):46-51.
[24]Li Y,Fang F,Ma N,et al.Feasibility study of transthoracic echocardiography for coronary slow flow phenomenon evaluation:validation by coronary angiography.Microcirculation,2016,23(4):277-282.
[25]李宜嘉,杨娅,聂绍平,等.超声心动图无创诊断冠状动脉慢血流现象可行性研究.中国超声医学杂志,2017,33(2):107-109.
[26]Erdogan T,Canga A,Kocaman SA,et al.Increased epicardial adipose tissue in patients with slow coronary flow phenomenon.Kardiol Pol,2012,70(9):903-909.
[27]Mazurek T.Proinflammatory capacity of adipose tissue—a new insights in the pathophysiology of atherosclerosis.Kardiol Pol,2009,67(10):1119-1124.
[28]Cetin MS,Ozcan Cetin EH,Aras D,et al.Coronary slow flow phenomenon:Not only low in flow rate but also in myocardial energy expenditure.Nutr Metab Cardiovasc Dis,2015,25(10):931-936.
[29]Wang YH,Ma CY,Zhang Y,et al.Layer-specific analysis of left ventricular myocardial contractility in patients with coronary slow-flow phenomenon.Clin Ultrasound J,2016,3(7):1-8.
[30]Wang YH,Ma CY,Zhang Y,et al.Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking-echocardiography in patients with coronary slow flow phenomenon.PLoS One,2015,10(2):e0117979.
[31]孟平平,李东东,朱丹,等.超声极速成像技术评价冠状动脉慢血流患者颈动脉脉搏波传导速度.中国医学影像技术,2017,33(1):17-20.
[32]Gulel O,Akcay M,Soylu K,et al.Left ventricular myocardial deformation parameters are affected by coronary slow flow phenomenon:A study of speckle tracking echocardiography.Echocardiography,2016,33(5):714-723.
[33]Wang YH,Zhang Y,Ma CY,et al.Evaluation of left and right atrial function in patients with coronary slow-flow phenomenon using two-dimensional speckle tracking echocardiography.Echocardiography,2016,33(6):871-880.
[34]Kemalosˇluz T,Eren M,Atasoy I,et al.Are biventricular systolic functions impaired in patient with coronoray slow flow?A prospective study with three dimensional speckle tracking.Int J Cardiovasc Imaging,2017,33(5):675-681.
[35]周宏林.冠状慢血流患者内皮功能研究和声学造影定量评估心肌微循环灌注研究.宁波:宁波大学,2010:1-58.
[36]Wang SH,Zhu N,Zhou HL,et al.Evaluation of myocardial perfusion in patients with coronary slow flow by myocardial contrast echocardiography.Zhonghua Xin Xue Guan Bing Za Zhi,2013,41(4):293-296.
[2]Hawkins BM,Stavrakis S,Rousan TA,et al.Coronary slow flow—prevalence and clinical correlations.Circ J,2012,76(4):936-942.
[3]Mangieri E,Macchiarelli G,Ciavolella M,et al.Slow coronary flow:Clinical and histopathological features inpatients with otherwise normal epicardial coronary arteries.Cathet Cardiovasc Diagn,1996,37(4):375-381.
[4]Yilmaz H,Demir I,Uyar Z.Clinical and coronary angiographic characteristics of patients with coronary slow flow.Acta Cardiol,2008,63(5):579-584.
[5]李阳,马春燕,刘爽,等.二维斑点追踪成像技术评价左心室不同部位心肌梗死患者右心室心肌功能.中国医学影像技术,2016,32(7):1047-1051.
[6]Tambe AA,Demany MA,Zimmerman HA,et al.Angina pectoris and slow flow velocity of dye in coronary arteries:A new angiographic finding.Am Heart J,1972,84(1):66-71.
[7]Li JJ,Xu B,Li ZC,et al.Is slow coronary flow associated with inflammation?Med Hypotheses,2006,66(3):504-508.
[8]Cin VG,Pekdemir H,Camsar A,et al.Diffuse intimal thickening of coronary arteries in slow coronary flow.Jpn Heart J,2003,44(6):907-919.
[9]Wang X,Geng LL,Nie SP.Coronary slow flow phenomenon:A local or systemic disease?Med Hypotheses,2010,75(3):334-337.
[10]Pekdemir H,Polat G,Cin VG,et al.Elevated plasma endothelin-1levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow.Int J Cardiol,2004,97(1):35-41.
[11]Beltrame JF,Limaye SB,Wuttke RD.Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon.Am Heart J,2003,146(1):84-90.
[12]Madak N,Nazli Y,Mergen H,et al.Acute phase reactants in patients with coronary slow flow phenomenon.Anadolu Kardiyol Derg,2010,10(5):416-420.
[13]Gokce M,Kaplan S,Tekelioglu Y,et al.Platelet function disorder in patients with coronary slow flow.Clin Cardiol,2005,28(3):145-148.
[14]Camsarl A,Pekdemir H,Cicek D,et al.Endothelin-1and nitric oxide concentrations and their response to exercise in patients with slow coronary flow.Circ J,2003,67(12):1022-1028.
[15]Yildiz A,Gur M,Yilmaz R,et al.Association of paraoxonase activity and coronary blood flow.Atherosclerosis,2008,197(1):257-263.
[16]Enli Y,Türk M,Akbay R,et al.Oxidative stress parameters in patients with slow coronary flow.Adv Ther,2008,25(1):37-44.
[17]Buchthal SD,den Hollander JA,Bairey Merz N,et al.Abnormal myocardial phosphorus-31nuclear magnetic resonance spectroscopy in women with chest pain but normal coronary angiograms.New Eng J Med,2000,342(12):829-835.
[18]Merih B,Emre Cumhur B,Salih T,et al.Assessment of left ventricular function and Tei index by tissue Doppler imaging in patients with slow coronary flow.Wiley J,2009,26(10):1167-1172.
[19]Elsherbiny IA.Left ventricular function and exercise capacity in patientswith slow coronary flow.Echocardiography,2012,29(2):158-164.
[20]Sevimli S,Büyükkaya E,Gündogdu F,et al.Left ventricular function inpatients with coronary slow flow:A tissue Doppler study.Turk Kardiyol Dern Ars,2007,35(5):360-365.
[21]Sezgin AT,Topal E,Barutcu I,et al.Impaired left ventricle filling in slow coronary flow phenomenon:An echo-Doppler Study.Angiology,2005,56(4):397-401.
[22]Fatih A,Fatih K,Koksal C,et al.The Effect of slow coronary flow on right and left ventricular performance.Med Princ Pract,2014,23(1):34-39.
[23]Yilmaz M,Ozluk F,Peker T,et al.Right ventricular function and its relation with TIMI frame count in the coronary slow flow phenomenon.Turk J Med Sci,2013,43(1):46-51.
[24]Li Y,Fang F,Ma N,et al.Feasibility study of transthoracic echocardiography for coronary slow flow phenomenon evaluation:validation by coronary angiography.Microcirculation,2016,23(4):277-282.
[25]李宜嘉,杨娅,聂绍平,等.超声心动图无创诊断冠状动脉慢血流现象可行性研究.中国超声医学杂志,2017,33(2):107-109.
[26]Erdogan T,Canga A,Kocaman SA,et al.Increased epicardial adipose tissue in patients with slow coronary flow phenomenon.Kardiol Pol,2012,70(9):903-909.
[27]Mazurek T.Proinflammatory capacity of adipose tissue—a new insights in the pathophysiology of atherosclerosis.Kardiol Pol,2009,67(10):1119-1124.
[28]Cetin MS,Ozcan Cetin EH,Aras D,et al.Coronary slow flow phenomenon:Not only low in flow rate but also in myocardial energy expenditure.Nutr Metab Cardiovasc Dis,2015,25(10):931-936.
[29]Wang YH,Ma CY,Zhang Y,et al.Layer-specific analysis of left ventricular myocardial contractility in patients with coronary slow-flow phenomenon.Clin Ultrasound J,2016,3(7):1-8.
[30]Wang YH,Ma CY,Zhang Y,et al.Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking-echocardiography in patients with coronary slow flow phenomenon.PLoS One,2015,10(2):e0117979.
[31]孟平平,李东东,朱丹,等.超声极速成像技术评价冠状动脉慢血流患者颈动脉脉搏波传导速度.中国医学影像技术,2017,33(1):17-20.
[32]Gulel O,Akcay M,Soylu K,et al.Left ventricular myocardial deformation parameters are affected by coronary slow flow phenomenon:A study of speckle tracking echocardiography.Echocardiography,2016,33(5):714-723.
[33]Wang YH,Zhang Y,Ma CY,et al.Evaluation of left and right atrial function in patients with coronary slow-flow phenomenon using two-dimensional speckle tracking echocardiography.Echocardiography,2016,33(6):871-880.
[34]Kemalosˇluz T,Eren M,Atasoy I,et al.Are biventricular systolic functions impaired in patient with coronoray slow flow?A prospective study with three dimensional speckle tracking.Int J Cardiovasc Imaging,2017,33(5):675-681.
[35]周宏林.冠状慢血流患者内皮功能研究和声学造影定量评估心肌微循环灌注研究.宁波:宁波大学,2010:1-58.
[36]Wang SH,Zhu N,Zhou HL,et al.Evaluation of myocardial perfusion in patients with coronary slow flow by myocardial contrast echocardiography.Zhonghua Xin Xue Guan Bing Za Zhi,2013,41(4):293-296.