心肌声学造影评价心脏X综合征心肌微循环障碍的应用进展

Myocardial contrast echocardiography in evaluation of myocardial microcirculation abnormalities in cardiac syndrome X

既往研究认为心脏X综合征(CSX)预后良好,但近年来研究认为CSX患者的心血管事件发生率较高。冠状动脉微血管功能异常对CSX的发生具有重要作用,部分CSX患者以微血管功能障碍短暂发作为起始的级联事件,最终导致心肌灌注受损、顽固性心肌缺血,进而导致胸部不适发作。因此,早期诊断评估心脏X综合征患者是否具有心肌微循环障碍具有非常重要的意义。心肌声学造影(MCE)可实时观察心肌及心内膜下微循环灌注,有效评估微血管功能障碍及心肌微循环,具有无创、安全性高、经济及检测方便等优点,是目前评估心肌微循环灌注的有效方法之一。本文就MCE在CSX心肌微循环障碍评价中的应用进展进行综述。

Previous studies have suggested that cardiac syndrome X(CSX)was to have good prognosis,but in recent years,studies have shown that patients with CSX have higher incidence of cardiovascular events.Abnormal coronary microvascular function plays an important role in the development of CSX,and some patients with CSX have transient episodes of microvascular dysfunction as the starting cascade of events that eventually lead to impaired myocardial perfusion,intractable myocardial ischemia,and consequently,episodes of chest discomfort.Therefore,early diagnosis and evaluation of patients with CSX for myocardial microcirculatory disorders is of great significance.Myocardial contrast echocardiography(MCE)can observe myocardial and subendocardial microcirculation perfusion in real time,,and can effectively evaluate microvascular dysfunction and myocardial microcirculation.It has the advantages of non-invasive,high safety,economic and convenient detection,and is currently one of the effective methods to assess myocardial microcirculation perfusion.This article reviews the application progress of MCE in the evaluation of myocardial microcirculation disturbance in CSX.