核素冠脉血管反应性试验评估INOCA患者微血管功能障碍伴血管痉挛性心绞痛1例

Evaluation of microvascular dysfunction with vasospastic angina pectoris in patient with INOCA by radionuclide coronary vascular reactivity test:a case report

笔者报道了1例应用核素冠脉血管反应性试验诊断为缺血伴非阻塞性冠状动脉疾病(INOCA)微血管功能障碍伴血管痉挛性心绞痛的患者,分别从临床症状、实验室检查结果及核素心肌灌注显像(MPI)特征等方面介绍该病的特点,并通过文献复习加深了对血管痉挛性心绞痛的认识。冠状动脉造影和核素MPI的结合能够精准评估INOCA患者血管自律运动障碍是扩张受限(微血管功能障碍)还是收缩增加(冠脉痉挛),特异性较高,并能够为INOCA的诊断分型、指导治疗及预测预后提供帮助。

The authors reported a case of diagnosis of microvascular dysfunction with vasospastic angina pectoris in patient with ischaemia and non-obstructive coronary arteries(INOCA)using radionuclide coronary vascular reactivity test.The characteristics of the disease were introduced from clinical symptoms,laboratory examination results,and radionuclide myocardial perfusion imaging.Through literature review,the recognition of microvascular dysfunction was deepened.The combination of coronary angiography and radionuclide myocardial perfusion imaging has complementary advantages,and the combination of the two can also accurately evaluate whether INOCA patients have limited vasodilation(microvascular dysfunction)or increased contraction(coronary spasm),has high specificity,and can diagnose and classify INOCA,guide treatment,and predict prognosis.