冠状动脉微血管功能障碍的诊断方法研究进展
|
摘要
冠状动脉微血管功能障碍是冠心病的一种特殊类型,与冠状动脉大血管不同,微血管不可通过冠状动脉造影直接显像,因而冠状动脉微血管功能障碍的诊断非常困难。目前冠状动脉微血管功能的评估方法多种多样,从传统的基于介入检查的冠状动脉血流储备,到近年来发展出了基于X射线、MRI、超声和放射性核素等影像学技术的新型冠状动脉微循环功能评估指标。现简要综述目前临床常用的冠状动脉微血管功能障碍的诊断方法、适用范围、优点与缺点、评估情况。
Coronary microvascular dysfunction( CMD) is a special type of coronary artery disease. Coronary microvascular cannot be directly imaged by coronary angiography,thus results in difficulty in diagnosing CMD. Nowadays,there are various examinations for coronary microvascular function,including traditional coronary flow reserve test based on interventional examination and non-invasive coronary microcirculation function tests based on X-ray,MRI,ultrasound,and radionuclide imaging. The paper briefly reviews the commonly used methods for diagnosing CMD,application scope,advantages and disadvantages,and assessment situation.
Coronary microvascular dysfunction( CMD) is a special type of coronary artery disease. Coronary microvascular cannot be directly imaged by coronary angiography,thus results in difficulty in diagnosing CMD. Nowadays,there are various examinations for coronary microvascular function,including traditional coronary flow reserve test based on interventional examination and non-invasive coronary microcirculation function tests based on X-ray,MRI,ultrasound,and radionuclide imaging. The paper briefly reviews the commonly used methods for diagnosing CMD,application scope,advantages and disadvantages,and assessment situation.
引文
[1]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:2.
[2]Jespersen L,Hvelplund A,Abildstrom SZ,et al.Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events[J].Eur Heart J,2012,33(6):734-744.
[3]Patel MR,Peterson ED,Dai D,et al.Low diagnostic yield of elective coronary angiography[J].N Engl J Med,2010,362(10):886-895.
[4]Ong P,Athanasiadis A,Borgulya G,et al.High prevalence of a pathological response to acetylcholine testing in patients with stable angina pectoris and unobstructed coronary arteries.The ACOVA Study(Abnormal Coronary Vasomotion in patients with stable angina and unobstructed coronary arteries)[J].J Am Coll Cardiol,2012,59(7):655-662.
[5]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:40
[6]Reis SE,Holubkov R,Conrad Smith AJ,et al.Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease:results from the NHLBI WISE study[J].Am Heart J,2001,141(5):735-741.
[7]Chareonthaitawee P,Kaufmann PA,Rimoldi O,et al.Heterogeneity of resting and hyperemic myocardial blood flow in healthy humans[J].Cardiovasc Res,2017,50(1):151-161.
[8]Kato D,Takashima H,Waseda K,et al.Feasibility and safety of intracoronary nicorandil infusion as a novel hyperemic agent for fractional flow reserve measurements[J].Heart Vessels,2015,30(4):477-483.
[9]Campisi R.Noninvasive assessment of coronary microvascular function in women at risk for ischemic heart disease[J].Int J Clin Pract,2008,62(2):300-307.
[10]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:10
[11]诸葛瑞琪,邵明凤,倪新海.冠状动脉微血管功能障碍临床诊断策略新进展[J].临床心血管病杂志,2016,32(5):436-441.
[12]陈红磊,廉哲勋.冠状动脉血流储备测量方法的研究进展[J].心血管病学进展,2009,30(S1):25-27.
[13]卢成,孙林,官兵.冠状动脉微循环功能评估的研究进展[J].医学综述,2016,22(3):537-541.
[14]Dimitrow PP,Galderisi M,Rigo F.The non-invasive documentation of coronary microcirculation impairment:role of transthoracic echocardiography[J].Cardiovasc Ultrasound,2005,3(1):18.
[15]Gibson CM,Cannon CP,Murphy SA,et al.Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs[J].Circulation,2000,101(2):125-130.
[16]张鹏飞,倪梅.校正TIMI帧数的技术原理和临床应用[J].心血管病学进展,2004,25(1):16-19.
[17]沈伟,王邦宁.冠状动脉微循环障碍诊治及其研究进展[J].心血管病学进展,2017,38(5):566-570.
[18]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:50.
[19]徐冰,何胜虎,徐日新,等,冠状动脉微血管功能障碍诊断方法的研究进展[J].中国全科医学,2016,19(26):3238-3242.
[20]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:45-46.
[21]Jerosch-Herold M,Seethamraju RT,Swingen CM,et al.Analysis of myocardial perfusion MRI[J].J Magn Reson Imaging,2004,19(6):758-770.
[22]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:47-48
[23]卢成,孙林,官兵.冠状动脉微循环功能评估的研究进展[J].医学综述,2016,22(3):537-541.
[24]Panza JA,Laurienzo JM,Curiel RV,et al.Investigation of the mechanism of chest pain in patients with angiographically normal coronary arteries using transesophageal dobutamine stress echocardiography[J].J Am Coll Cardiol,1997,29(2):293-301.
[25]Zouridakis EG,Cox ID,Garcia-Moll X,et al.Negative stress echocardiographic responses in normotensive and hypertensive patients with angina pectoris,positive exercise stress testing,and normal coronary arteriograms[J].Heart,2000,83(2):141-146.
[2]Jespersen L,Hvelplund A,Abildstrom SZ,et al.Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events[J].Eur Heart J,2012,33(6):734-744.
[3]Patel MR,Peterson ED,Dai D,et al.Low diagnostic yield of elective coronary angiography[J].N Engl J Med,2010,362(10):886-895.
[4]Ong P,Athanasiadis A,Borgulya G,et al.High prevalence of a pathological response to acetylcholine testing in patients with stable angina pectoris and unobstructed coronary arteries.The ACOVA Study(Abnormal Coronary Vasomotion in patients with stable angina and unobstructed coronary arteries)[J].J Am Coll Cardiol,2012,59(7):655-662.
[5]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:40
[6]Reis SE,Holubkov R,Conrad Smith AJ,et al.Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease:results from the NHLBI WISE study[J].Am Heart J,2001,141(5):735-741.
[7]Chareonthaitawee P,Kaufmann PA,Rimoldi O,et al.Heterogeneity of resting and hyperemic myocardial blood flow in healthy humans[J].Cardiovasc Res,2017,50(1):151-161.
[8]Kato D,Takashima H,Waseda K,et al.Feasibility and safety of intracoronary nicorandil infusion as a novel hyperemic agent for fractional flow reserve measurements[J].Heart Vessels,2015,30(4):477-483.
[9]Campisi R.Noninvasive assessment of coronary microvascular function in women at risk for ischemic heart disease[J].Int J Clin Pract,2008,62(2):300-307.
[10]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:10
[11]诸葛瑞琪,邵明凤,倪新海.冠状动脉微血管功能障碍临床诊断策略新进展[J].临床心血管病杂志,2016,32(5):436-441.
[12]陈红磊,廉哲勋.冠状动脉血流储备测量方法的研究进展[J].心血管病学进展,2009,30(S1):25-27.
[13]卢成,孙林,官兵.冠状动脉微循环功能评估的研究进展[J].医学综述,2016,22(3):537-541.
[14]Dimitrow PP,Galderisi M,Rigo F.The non-invasive documentation of coronary microcirculation impairment:role of transthoracic echocardiography[J].Cardiovasc Ultrasound,2005,3(1):18.
[15]Gibson CM,Cannon CP,Murphy SA,et al.Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs[J].Circulation,2000,101(2):125-130.
[16]张鹏飞,倪梅.校正TIMI帧数的技术原理和临床应用[J].心血管病学进展,2004,25(1):16-19.
[17]沈伟,王邦宁.冠状动脉微循环障碍诊治及其研究进展[J].心血管病学进展,2017,38(5):566-570.
[18]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:50.
[19]徐冰,何胜虎,徐日新,等,冠状动脉微血管功能障碍诊断方法的研究进展[J].中国全科医学,2016,19(26):3238-3242.
[20]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:45-46.
[21]Jerosch-Herold M,Seethamraju RT,Swingen CM,et al.Analysis of myocardial perfusion MRI[J].J Magn Reson Imaging,2004,19(6):758-770.
[22]Crea F,Lanza GA,Camici PG.冠状动脉微血管功能障碍.曾定尹,孙英贤主译[M].上海:上海科学技术出版社,2017:47-48
[23]卢成,孙林,官兵.冠状动脉微循环功能评估的研究进展[J].医学综述,2016,22(3):537-541.
[24]Panza JA,Laurienzo JM,Curiel RV,et al.Investigation of the mechanism of chest pain in patients with angiographically normal coronary arteries using transesophageal dobutamine stress echocardiography[J].J Am Coll Cardiol,1997,29(2):293-301.
[25]Zouridakis EG,Cox ID,Garcia-Moll X,et al.Negative stress echocardiographic responses in normotensive and hypertensive patients with angina pectoris,positive exercise stress testing,and normal coronary arteriograms[J].Heart,2000,83(2):141-146.