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Association of coronary microvascular endothelial dysfunction with vulnerable plaque characteristics in early coronary atherosclerosis.

冠状动脉粥样硬化早期冠状动脉微血管内皮功能障碍与易损斑块特征的关系。

  • 影响因子:2.41
  • DOI:10.4244/EIJ-D-19-00265
  • 作者列表:"Godo S","Corban MT","Toya T","Gulati R","Lerman LO","Lerman A
  • 发表时间:2020-08-28
Abstract

AIMS:The aim of this study was to test the hypothesis that coronary microvascular endothelial dysfunction (CMED) is associated with epicardial coronary atherosclerosis. METHODS AND RESULTS:We performed a cross-sectional analysis of a comprehensive invasive assessment of coronary physiology with a focus on endothelium-dependent coronary microvascular function and virtual-histology intravascular ultrasound (VH-IVUS) in a total of 148 consecutive patients with chest pain and angiographically normal coronary arteries or non-obstructive coronary artery disease (CAD). Endothelium-dependent coronary vascular reactivity was evaluated by graded doses of intracoronary acetylcholine (ACh). CMED was defined as a percent increase in coronary blood flow of ≤50% in response to ACh. Patients with CMED (n=87) showed more vulnerable plaque characteristics as compared to those without (n=61); they showed higher plaque burden in association with larger necrotic core volume and higher frequency of imaged arteries containing at least one VH-IVUS-derived thin-capped fibroatheroma (TCFA) (n=22 [25.3%] vs 5 [8.2%], p=0.008). Multivariate logistic regression analysis revealed that CMED was an independent predictor of VH-IVUS-derived TCFA (adjusted odds ratio 2.28 [95% confidence interval: 1.30-4.02], p=0.004). CONCLUSIONS:Independently of conventional coronary risk factors, CMED was associated with vulnerable plaque characteristics in patients with non-obstructive CAD.

摘要

目的: 本研究的目的是验证冠状动脉微血管内皮功能障碍 (CMED) 与心外膜冠状动脉粥样硬化相关的假设。 方法和结果: 我们对冠状动脉生理学的全面侵入性评估进行了横断面分析,重点是内皮依赖性冠状动脉微血管功能和虚拟组织学血管内超声 (vh-ivus) 在总共148名连续的胸痛患者和血管造影正常的冠状动脉或非阻塞性冠状动脉疾病 (CAD)。通过冠状动脉内乙酰胆碱 (ACh) 的分级剂量评估内皮依赖性冠状动脉血管反应性。CMED被定义为响应于ACh的冠状动脉血流增加 ≤ 50% 的百分比。与没有CMED的患者 (n = 61) 相比,CMED患者 (n = 87) 显示出更易损的斑块特征; 他们显示出更高的斑块负荷与更大的坏死核心体积和更高频率的成像动脉包含至少一个VH-IVUS衍生的薄盖纤维粥样瘤 (TCFA) (n = 22 [25.3%] vs 5 [8.2%],p = 0.008)。多因素logistic回归分析显示,CMED是vh-ivus衍生TCFA的独立预测因子 (校正比值比2.28 [95% 可信区间: 1.30-4.02],p = 0.004)。 结论: 在非梗阻性CAD患者中,CMED与易损斑块特征无关。

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影响因子:2.41
发表时间:2020-06-12
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影响因子:1.67
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作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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