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Myocardial infarction with non-obstructive coronary arteries: A comprehensive review and future research directions 被引量:9
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作者 Rafael Vidal-Perez Charigan Abou Jokh Casas +6 位作者 Rosa Maria Agra-Bermejo Belén Alvarez-Alvarez Julia Grapsa Ricardo Fontes-Carvalho Pedro Rigueiro Veloso Jose Maria Garcia Acuña Jose Ramon Gonzalez-Juanatey 《World Journal of Cardiology》 CAS 2019年第12期305-315,共11页
Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries(MINOCA).This acute corona... Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries(MINOCA).This acute coronary syndrome differs from type 1 myocardial infarction(MI)regarding patient characteristics,presentation,physiopathology,management,treatment,and prognosis.Two-thirds of MINOCA subjects present ST-segment elevation;MINOCA patients are younger,are more often female and tend to have fewer cardiovascular risk factors.Moreover,MINOCA is a working diagnosis,and defining the aetiologic mechanism is relevant because it affects patient care and prognosis.In the absence of relevant coronary artery disease,myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries,coronary microcirculation,or both.Epicardial causes of MINOCA include coronary plaque disruption,coronary dissection,and coronary spasm.Microvascular MINOCA mechanisms involve microvascular coronary spasm,takotsubo syndrome(TTS),myocarditis,and coronary thromboembolism.Coronary angiography with non-significant coronary stenosis and left ventriculography are first-line tests in the differential study of MINOCA patients.The diagnostic arsenal includes invasive and non-invasive techniques.Medical history and echocardiography can help indicate vasospasm or thrombosis,if one finite coronary territory is affected,or specify TTS if apical ballooning is present.Intravascular ultrasound,optical coherence tomography,and provocative testing are encouraged.Cardiac magnetic resonance is a cornerstone in myocarditis diagnosis.MINOCA is not a benign diagnosis,and its polymorphic forms differ in prognosis.MINOCA care varies across centres,and future multi-centre clinical trials with standardized criteria may have a positive impact on defining optimal cardiovascular care for MINOCA patients. 展开更多
关键词 Myocardial infarction non-obstructive coronary Myocardial infarction with non-obstructive coronary arteries Management PROGNOSIS
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Presentation and outcome of myocardial infarction with nonobstructive coronary arteries in coronavirus disease 2019 被引量:1
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作者 Kevin John Amos Lal +2 位作者 Nitish Sharma Amr ElMeligy Ajay K Mishra 《World Journal of Critical Care Medicine》 2022年第3期129-138,共10页
Among the cardiac complications of coronavirus disease 2019(COVID-19),one increasingly reported in the literature is myocardial infarction with nonobstructive coronaries(MINOCA).We reviewed all reported cases of MINOC... Among the cardiac complications of coronavirus disease 2019(COVID-19),one increasingly reported in the literature is myocardial infarction with nonobstructive coronaries(MINOCA).We reviewed all reported cases of MINOCA in COVID-19 patients to summarize its clinical features,evaluation,and treatment.We performed a literature search in Pubmed using the search terms‘COVID-19’and‘MINOCA’or‘non-obstructive coronaries’.Among the reported cases,the mean age was 61.5 years(SD±13.4),and 50%were men.Chest pain was the presenting symptom in five patients(62.5%),and hypertension was the most common comorbidity(62.5%).ST-elevation was seen in most patients(87.5%),and the overall mortality rate was 37.5%.MINOCA in COVID-19 is an entity with a broad differential diagnosis.Therefore,a uniform algorithm is needed in its evaluation to ensure timely diagnosis and management. 展开更多
关键词 COVID-19 Myocardial infarction with non-obstructive coronary arteries OUTCOME
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Non-obstructive coronary artery disease and cardiovascular events in patients with angina-like chest pain detected by coronary angiography:a Chinese cohort study
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作者 Huiwen Zhang Xi Zhao +3 位作者 Yuanlin Guo Naqiong Wu Chenggang Zhu Jianjun Li 《中国循环杂志》 CSCD 北大核心 2018年第S01期145-145,共1页
Objective The utility of non-obstructive coronary artery diseases(NOCAD) in cardiovascular events (CVE) among Chinese patients has less been evaluated. Our objective was to investigate the prognostic value of NOCAD in... Objective The utility of non-obstructive coronary artery diseases(NOCAD) in cardiovascular events (CVE) among Chinese patients has less been evaluated. Our objective was to investigate the prognostic value of NOCAD in patients with angina-like chest pain detected by coronary angiography (CAG) in a large Chinese cohort study. 展开更多
关键词 non-obstructive coronary artery diseases cardiovascular events coronary ANGIOGRAPHY
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慢性冠脉综合征患者血尿酸及钙化积分对CT-FFR的影响
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作者 徐彧 杜丰夷 +2 位作者 袁小佳 赵天佐 陈正光 《中国中西医结合影像学杂志》 2024年第2期175-179,共5页
目的:探讨血尿酸及钙化积分对深度学习算法下冠脉综合征(CCS)患者血流储备分数(CT-FFR)的影响。方法:回顾性分析150例冠状动脉(冠脉)CTA(CCTA)示靶血管狭窄的慢性CCS患者,采用深度学习法计算其CT-FFR,取3支靶血管中最低值作为该患者CT-F... 目的:探讨血尿酸及钙化积分对深度学习算法下冠脉综合征(CCS)患者血流储备分数(CT-FFR)的影响。方法:回顾性分析150例冠状动脉(冠脉)CTA(CCTA)示靶血管狭窄的慢性CCS患者,采用深度学习法计算其CT-FFR,取3支靶血管中最低值作为该患者CT-FFR,按CT-FFR>0.8及CT-FFR≤0.8分为正常组77例、异常组73例,比较2组血尿酸值及总钙化积分;采用SPSS26.0统计软件对CT-FFR、血尿酸、钙化积分行Pearson分析;使用logistic回归分析且通过ROC曲线评估其诊断效能。结果:2组在钙化积分上差异有统计学意义(Z=-5.958,P<0.05),而血尿酸差异无统计学意义(t=-0.448,P>0.05);Pearson相关分析得出,钙化积分与CT-FFR呈显著负相关(r=-0.556,P<0.05);ROC曲线的AUC为0.782,且达到病变程度(CT-FFR≤0.8)的钙化积分阈值为313.05分,约登指数为0.464,其诊断准确率为78.2%,敏感度为68.5%,特异度为77.9%。结论:冠脉钙化积分可能影响CTFFR,可预测功能性缺血的发生,即钙化积分越高,血管功能越差,CT-FFR越低,缺血越严重。CCS患者血尿酸是否与CT-FFR存在相关性有待进一步研究。 展开更多
关键词 血尿酸 钙化积分 血流储备分数 冠状动脉 心肌缺血
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基于慢性心肌缺血小鼠模型探究心电图T波低平的电生理机制
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作者 王兆博 潘熠 +1 位作者 林谦 钟菊迎 《中国比较医学杂志》 CAS 北大核心 2024年第6期54-62,共9页
目的 建立通过稳定的冠心病慢性心肌缺血小鼠模型,初步阐述缺血状态下T波低平的电生理原理。方法 将APOE-/-小鼠随机分为模型组和降脂药(lipid-lowering drug, LLD)组,高脂饮食喂养3个月,同时设立C57BL/6J小鼠作为空白组。检测造模前后... 目的 建立通过稳定的冠心病慢性心肌缺血小鼠模型,初步阐述缺血状态下T波低平的电生理原理。方法 将APOE-/-小鼠随机分为模型组和降脂药(lipid-lowering drug, LLD)组,高脂饮食喂养3个月,同时设立C57BL/6J小鼠作为空白组。检测造模前后小鼠心电图变化,通过核素PET/CT扫描评估心脏血流灌注情况,使用主动脉苏木伊红(hematoxylin-eosin, HE)染色和油红染色评估斑块动脉粥样硬化(atherosclerosis, AS)病理。同时,分离小鼠心肌细胞并记录心肌细胞动作电位。结果 高脂喂养3个月后模型组小鼠的胆固醇(cholesterol, CHO)和低密度脂蛋白(low-density lipoprotein, LDL-C)显著升高,同时主动脉出现脂质斑块。LLD组病变减少,空白组无斑块。心肌核素扫描显示模型组小鼠的心肌血流灌注显著低于LLD组和空白组。小鼠心电图显示模型组和LLD组的T/QRS显著降低,空白组无明显改变。记录心肌细胞动作电位发现,缺血的内层心肌细胞复极速率增加,内外电位差减小是T波低平的主要电生理机制。结论 APOE-/-小鼠可用于慢性心肌缺血小鼠模型,缺血状态下内层心肌复极速率的增加可能是心电图中T波降低的主要原因。 展开更多
关键词 冠心病 慢性心肌缺血 小鼠心电图 T波低平
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基于“心脾相关”论治缺血伴非阻塞性冠状动脉疾病 被引量:1
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作者 黄佳敏 曾敏 +2 位作者 谢煌烈 韩鹏宇 郑朝阳 《世界中西医结合杂志》 2024年第1期171-175,181,共6页
缺血伴非阻塞性冠状动脉疾病(Ischaemia with non-obstructive coronary arteries,INOCA)是临床常见的心血管疾病之一,因胸闷等不适症状反复而严重影响患者生活质量。国医大师邓铁涛提出“五脏相关,心脾为要”的论治体系,INOCA属本虚标... 缺血伴非阻塞性冠状动脉疾病(Ischaemia with non-obstructive coronary arteries,INOCA)是临床常见的心血管疾病之一,因胸闷等不适症状反复而严重影响患者生活质量。国医大师邓铁涛提出“五脏相关,心脾为要”的论治体系,INOCA属本虚标实,本虚为心脾肾虚,重在心脾同调,标实为痰、瘀为主,甚者痰瘀互结。治疗上当以养心为主,重视健脾,兼顾固肾、疏肝理肺之法,辨证施治,屡见奇效。 展开更多
关键词 缺血伴非阻塞性冠状动脉疾病 心脾相关 胸痹心痛
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Role of coronary physiology in the contemporary management of coronary artery disease 被引量:2
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作者 Neil Ruparelia Rajesh K Kharbanda 《World Journal of Clinical Cases》 SCIE 2015年第2期148-155,共8页
Coronary artery disease(CAD) remains the leading cause of death worldwide with approximately 1 in 30 patients with stable CAD experiencing death or acute myocardial infarction each year. The presence and extent of res... Coronary artery disease(CAD) remains the leading cause of death worldwide with approximately 1 in 30 patients with stable CAD experiencing death or acute myocardial infarction each year. The presence and extent of resultant myocardial ischaemia has been shown to confer an increased risk of adverse outcomes. Whilst, optimal medical therapy(OMT) forms the cornerstone of the management of patients with stable CAD, a significant number of patients present with ischaemia refractory to OMT. Historically coronary angiography alone has been used to determine coronary lesion severity in both stable and acute settings. It is increasingly clear that this approach fails to accurately identify the haemodynamic significance of lesions; especially those that are visually "intermediate" in severity. Revascularisation based upon angiographic appearances alone may not reduce coronary events above OMT. Technological advances have enabled the measurement of physiological indices including the fractional flow reserve, the index of microcirculatory resistance and the coronary flow reserve. The integration of these parameters into the routine management of patients presenting to the cardiac catheterization laboratory with CAD represents a critical adjunctive tool in the optimal management of these patients by identifying patients that would most benefit from revascularisation and importantly also highlighting patients that would not gain benefit and therefore reducing the likelihood of adverse outcomes associated with coronary revascularisation. Furthermore, these techniques are applicable to a broad range of patients including those with left main stem disease, proximal coronary disease, diabetes mellitus, previous percutaneous coronary intervention and with previous coronary artery bypass grafting. This review will discuss current concepts relevant to coronary physiology assessment, its role in the management of both stable and acute patients and future applications. 展开更多
关键词 ischaemia coronary PHYSIOLOGY coronary FLOW RESERVE Fractional FLOW RESERVE coronary artery disease
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Non-obstructive Coronary Artery Disease in Chinese Patients with Angina Diagnosed by Coronary Angiography:A Retrospective Study 被引量:5
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作者 Chengfei Peng Shaoping Nie +5 位作者 Yingxian Sun Hui Chen Zuyi Yuan Yanjun Gong Xiaozeng Wang Yaling Han 《Cardiology Discovery》 2021年第4期223-227,共5页
Objective:This study aimed to estimate the proportion of non-obstructive coronary artery disease(CAD)patients in large percutaneous coronary intervention(PCI)centers in China.Methods:The study was conducted at 6 large... Objective:This study aimed to estimate the proportion of non-obstructive coronary artery disease(CAD)patients in large percutaneous coronary intervention(PCI)centers in China.Methods:The study was conducted at 6 large PCI centers in China from January 1,2013 to December 31,2015.Demographic and clinical data were collected from medical records,prescription records,and laboratory reports of patients with symptoms of angina who underwent coronary angiography(CAG).Results:A total of 1713 patients were consecutively screened,1600 of whom were included in the study.CAG showed that 300 patients had non-obstructive CAD while 1300 had obstructive CAD.Among the 300 patients with non-obstructive CAD,203 displayed mild coronary stenosis(20%-49%)and 91 had normal coronary status(ie,<20%stenosis).Of the 1300 patients with obstructive CAD,61.6%(801/1300)had typical symptoms of angina,compared with 49.3%(148/300)for patients with nonobstructive CAD.In addition,there were more women than men in the non-obstructive CAD group,whereas the reverse was observed among obstructive CAD patients.Conclusion:The prevalence of non-obstructive CAD in the Chinese population with coronary heart disease was estimated to be approximately 20%.Additionally,typical angina symptoms were correlated with obstructive CAD,whereas female gender was identified as a risk factor for non-obstructive CAD. 展开更多
关键词 non-obstructive coronary artery disease Percutaneous coronary intervention coronary angiography coronary stenosis
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非阻塞性冠状动脉缺血疾病微循环和左室舒张功能关系的探讨
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作者 姜涛 陈亚南 +2 位作者 郭秋红 王红 翟玉民 《中国循证心血管医学杂志》 2023年第5期565-568,577,共5页
目的 探讨非阻塞性冠状动脉(冠脉)缺血疾病患者微循环功能和左室舒张功能之间的关系。方法 入选2018年12月至2021年10月就诊于开封市中医院心内科,有明显胸痛、胸闷症状,但冠脉造影或冠脉CT血管成像结果显示正常或无严重狭窄(<50%)... 目的 探讨非阻塞性冠状动脉(冠脉)缺血疾病患者微循环功能和左室舒张功能之间的关系。方法 入选2018年12月至2021年10月就诊于开封市中医院心内科,有明显胸痛、胸闷症状,但冠脉造影或冠脉CT血管成像结果显示正常或无严重狭窄(<50%)的患者210例为研究对象。所有患者均行超声心动图检查,测量二尖瓣血流速度E峰(E)、二尖瓣环组织多普勒速度(e’),以E/e’表示左室舒张功能;应用三磷酸腺苷负荷心肌声学造影(MCE)评估冠脉血流储备(CFR)反映左室微循环功能,根据CFR值分为正常组(CFR≥2,n=134)以及微循环功能障碍(CMD)组(CFR<2,n=76),通过多因素Logistic回归分析明确微循环功能和左室舒张功能之间是否存在相关性。结果 与正常组相比,CMD组年龄明显增高,合并高血压、糖尿病及房颤比例较正常组明显增多(P<0.05);在心脏超声方面,CMD组左室质量指数(LVmassi)、室间隔厚度均高于正常组[106.5 (90~131)vs.98.1 (72~128),P=0.039]、[11.4(8.5~13.1)vs.9.6 (7.4~12.5),P=0.047],差异均有统计学意义。多因素Logistic回归分析显示:年龄、糖尿病是非阻塞性冠脉缺血疾病患者发生微循环功能障碍的预测因素,而针对该人群,左室舒张功能障碍和微循环功能障碍之间无明显相关性。结论 非阻塞性冠脉缺血疾病患者左室舒张功能和微循环功能之间无明显相关性。 展开更多
关键词 非阻塞性冠状动脉缺血疾病 舒张功能 微循环功能 冠脉血流储备
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心律失常、心电图心肌缺血与冠状动脉造影的对比分析 被引量:5
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作者 宋德明 方五旺 黄进 《临床心电学杂志》 2003年第4期229-231,共3页
目的 通过选择性冠状动脉造影的对比分析 ,评估心律失常、心电图心肌缺血与冠状动脉病变的相关性。方法 患者根据典型、不典型的心绞痛与无症状的心电图心肌缺血分为A、B和C三组进行选择性冠状动脉造影。结果 A组 33例有冠状动脉病... 目的 通过选择性冠状动脉造影的对比分析 ,评估心律失常、心电图心肌缺血与冠状动脉病变的相关性。方法 患者根据典型、不典型的心绞痛与无症状的心电图心肌缺血分为A、B和C三组进行选择性冠状动脉造影。结果 A组 33例有冠状动脉病变 ,占 91 6 7% ;B组仅 5例有冠状动脉病变 ,占14 2 9% ;C组 2 0例有冠状动脉病变 ,占 6 2 5 0 % ;右冠状动脉 (RCA)病变在心电图上易出现下壁部位心梗 ,2 2 / 30占 73 33% ;左冠状动脉回旋支 (LCX)病变时主要在心电图上表现下壁与正后壁部位 ,分别为 11/ 19占 5 7 89%与 7/ 19占 36 84 % ;左前降支 (LAD)病变在心电图导联以前壁多见 2 9/ 36占 80 5 6 %。结论 心律失常虽然是一个判断因素之一 ,但无典型心绞痛或心电图心肌缺血改变 ,其冠心病发生率低 ;而无症状性心肌缺血临床易忽视 ,识别与及早治疗是减少心脏事件的重要手段。 展开更多
关键词 心律失常 心电图 心肌缺血 冠状动脉造影 心绞痛
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降脂治疗潜在改善稳定型冠心病患者短暂性心肌缺血发作——DUAAL研究启示 被引量:2
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作者 靳立军 崔同涛 《循证医学》 CSCD 2011年第6期328-333,共6页
1 文献来源 Deanfield JE, Sellier P, Thaulow E, et al. Potent anti-ischaemic effects of statins inchronic stable angina: Incremental benefit beyond lipid lowering.9 [J]. Eur Heart J, 2010,31 (21) : 2650-2659.
关键词 冠状动脉粥样硬化性心脏病 短暂性心肌缺血 他汀类药物 联合药物治疗
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C-反应蛋白与急性冠状动脉综合征关系的临床研究
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作者 谭文锋 张荫川 +4 位作者 余泽洪 黄振文 汤立军 古国荣 陈林祥 《岭南心血管病杂志》 2001年第2期118-119,共2页
目的 通过比较急性冠状动脉综合征 (ACS)患者与健康正常人血浆C 反应蛋白 (CRP)浓度的变化 ,探讨炎症反应在ACS发病所起的作用。方法 对 2 3例急性心肌梗死 (AMI)和 36例不稳定型心绞痛 (UAP)患者在急性发病时测定血浆CRP浓度 ,并行 2... 目的 通过比较急性冠状动脉综合征 (ACS)患者与健康正常人血浆C 反应蛋白 (CRP)浓度的变化 ,探讨炎症反应在ACS发病所起的作用。方法 对 2 3例急性心肌梗死 (AMI)和 36例不稳定型心绞痛 (UAP)患者在急性发病时测定血浆CRP浓度 ,并行 2 4h动态心电图检查记录缺血总负荷。结果 AMI和UAP患者血浆CRP浓度明显比健康正常人高 (P <0 0 1) ,缺血总负荷大于 10 0 0mm·min与小于 10 0 0mm·minACS患者中血浆CRP浓度无显著性差异 (P >0 0 5 )。结论 CRP与冠状动脉 (冠脉 )斑块活动有关 ,与心肌缺血的程度无关 ,炎症反应是导致ACS发生的原因之一。 展开更多
关键词 C-反应蛋白 斑块 缺血 急性冠状动脉综合征 冠心病
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从瘀血论治非阻塞性冠状动脉缺血疾病经验撷要 被引量:1
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作者 韩烁 孟昭阳 +1 位作者 侯媛 辛来运 《中国中医药现代远程教育》 2022年第19期160-162,共3页
非阻塞性冠状动脉缺血疾病(Ischaemia with non-obstructive coronary arteries,INOCA)是临床常见的心血管系统疾病,临床主要表现为胸痛、胸闷、心悸不适等症状,西医治疗尚缺乏直接有效的管理措施。中医认为瘀血是本病发生发展的重要证... 非阻塞性冠状动脉缺血疾病(Ischaemia with non-obstructive coronary arteries,INOCA)是临床常见的心血管系统疾病,临床主要表现为胸痛、胸闷、心悸不适等症状,西医治疗尚缺乏直接有效的管理措施。中医认为瘀血是本病发生发展的重要证候因素,贯穿疾病始终,且活血化瘀治疗INOCA在临床实践中也颇得良效。基于此,此文以瘀血为基本点,简要概述INOCA与瘀血之间的相关性,并结合瘀血的不同证型探讨临床论治INOCA的经验体会,以期为非阻塞性冠状动脉缺血疾病的临床论治提供更多思路。 展开更多
关键词 瘀血 非阻塞性冠状动脉缺血疾病 活血化瘀 胸痹
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Is Takotsubo cardiomyopathy still looking for its own nosological identity?
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作者 Riccardo Scagliola Gian Marco Rosa 《World Journal of Cardiology》 2022年第10期557-560,共4页
Despite several efforts to provide a proper nosological framework for Takotsubo cardiomyopathy(TCM),this remains an unresolved matter in clinical practice.Several clinical,pathophysiologic and histologic findings supp... Despite several efforts to provide a proper nosological framework for Takotsubo cardiomyopathy(TCM),this remains an unresolved matter in clinical practice.Several clinical,pathophysiologic and histologic findings support the conceivable hypothesis that TCM could be defined as a unique pathologic entity,rather than a distinct subset of myocardial infarction with non-obstructive coronary arteries.Further investigations are needed in order to define TCM with the most appropriate disease taxonomy. 展开更多
关键词 Takotsubo cardiomyopathy Myocardial infarction with non-obstructive coronary arteries Disease classification
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Surgical outcome and clinical follow-up in patients with symptomatic myocardial bridging 被引量:18
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作者 HUANG Xiao-hong WANG Shui-yun +6 位作者 XU Jian-ping SONG Yun-hu SUN Han-song TANG Yue DONG Chao YANG Yue-jin HU Sheng-shou 《Chinese Medical Journal》 SCIE CAS CSCD 2007年第18期1563-1566,共4页
Background Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD) may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment fo... Background Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD) may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment for symptomatic myocardial bridging remains undetermined. This study assessed the middle- and long-term results of surgical treatment for symptomatic myocardial bridging. Methods From 1997 to 2006, 37 463 patients received selective coronary angiography in the Fuwai Cardiovascular Hospital, Beijing, China. Of these, 484 patients had angiographic diagnosis of myocardial bridging. Of the 484 patients, 35 underwent surgery for treatment of myocardial bridging with significant systolic arterial compression. Among the surgical treatment patients, 24 presented with other cardiac disorders, and the remaining 11 symptomatic patients with isolated myocardial bridging were included in the follow-up study. Results The angiographic prevalence of myocardial bridging was 1.3% in this study. The coronary angiographies of the 11 patients revealed myocardial bridging in the middle segment of LAD causing systolic compression 〉75% (ranging from 75% to 90%). The mean age of patients was 48,4 years. Surgical myotomy was performed in 3 patients and coronary artery bypass grafting (CABG) in 8 patients. Eight patients were operated on with an off-pump approach and 3 with a cardiopulmonary bypass technique after median sternotomy. Conversion to on-pump CABG surgery was necessary in 1 patient because of perforation of the right ventricle. The left internal mammary artery was used in all patients with CABG. The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death or other major in-hospital complications. All of the patients were followed up clinically. The median follow-up was 35.3 months (range: 6 to 120 months). Nine patients were free from symptoms and one of them continued taking beta blockers. The remaining 2 patients with myotomy had atypical chest pain. One received coronary angiography again and no stenosis was found two years after operation; while exercise testing was performed in the other patient and revealed no evidence of myocardial ischaemia. None of the patients sustained a myocardial infarction or other major adverse cardiac events (death or vessel revascularization) during follow-up. Conclusions Myocardial bridging is a relatively common angiographic finding. Surgical myotomy or CABG should be limited to patients who are refractory to oral medication. Surgical relief of myocardial ischaemia due to systolic compression of intramyocardial coronary arteries can be accomplished with low operative risk and excellent middle- and long-term results, 展开更多
关键词 myocardial bridging myocardial ischaemia MYOTOMY coronary artery bypass grafting coronary angiography
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缺血伴非阻塞性冠状动脉疾病的影像学诊断现状及研究进展 被引量:1
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作者 李琳琳 王永德 李剑明 《国际放射医学核医学杂志》 2022年第11期685-691,共7页
缺血伴非阻塞性冠状动脉疾病(INOCA)的发病率较高,患者的胸痛症状多不典型且表现多样,同时其分型较多,因此极易被患者自身和临床医师所忽视。随着临床对INOCA的致病原因和不良预后认识的不断加深,近年来用于INOCA诊断的无创或有创方法... 缺血伴非阻塞性冠状动脉疾病(INOCA)的发病率较高,患者的胸痛症状多不典型且表现多样,同时其分型较多,因此极易被患者自身和临床医师所忽视。随着临床对INOCA的致病原因和不良预后认识的不断加深,近年来用于INOCA诊断的无创或有创方法的研究和应用进展快速。INOCA的致病原因包括心外膜冠状动脉痉挛(CAS)和微血管功能障碍(CMD)。因此,各种诊断方法基本围绕CAS和CMD进行。通过诊断并分析其致病原因,最终实现对INOCA患者的针对性治疗,改善患者的症状、生活质量和预后。笔者主要对INOCA的诊断现状和研究进展进行综述,以提高临床医师对INOCA的认识、深入了解INOCA相关的影像学诊断手段。 展开更多
关键词 冠状血管 缺血伴非阻塞性冠状动脉疾病 心外膜冠状动脉痉挛 微血管功能障碍 影像诊断
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