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JACC:左主干冠状动脉狭窄与肺动脉高压和心绞痛相关性研究

2017-06-12 MedSci MedSci原创

左主干冠状动脉(LMCA)狭窄越来越多地被认为是肺动脉高压(PAH)导致心绞痛的主要原因之一。近日,在国际心血管权威杂志JACC上发表了一篇关于探索LMCA狭窄与肺动脉高压和心绞痛之间关系的临床研究。该研究旨在调查肺动脉高压和心绞痛或者有心绞痛临床表现患者的LMCA狭窄的流行病学情况,确定使用计算机断层扫描冠状动脉造影(CTCA)进行筛查的有效性,并对经皮冠状动脉介入治疗(PCIs)的安全性和有效

左主干冠状动脉(LMCA)狭窄越来越多地被认为是肺动脉高压(PAH)导致心绞痛的主要原因之一。近日,在国际心血管权威杂志JACC上发表了一篇关于探索LMCA狭窄与肺动脉高压和心绞痛之间关系的临床研究。该研究旨在调查肺动脉高压和心绞痛或者有心绞痛临床表现患者的LMCA狭窄的流行病学情况,确定使用计算机断层扫描冠状动脉造影(CTCA)进行筛查的有效性,并对经皮冠状动脉介入治疗(PCIs)的安全性和有效性进行评估。

本研究对所有在2008年5月1日至2013年12月31日期间入组的765名肺动脉高压和心绞痛或有心绞痛症状的患者进行了计算机断层扫描冠状动脉造影检查,对选择性冠脉造影结果显示有LMCA的患者行PCI治疗。

研究结果显示,有94名患者的CTCA结果异常,并进行了选择性冠脉造影检查。在这94名患者中,有48名患者的LMCA狭窄率≥50%。45名患者接受了PCI和支架置入治疗,其中41名患者的持续性心绞痛症状有所缓解。剩余3名患者接受外科肺动脉分流术治疗。PCI术后9个月,有5名患者的LMCA出现了再狭窄,并成功再次接受PCI治疗。LMCA狭窄率≥50%的最好预测因素是肺动脉直径≥40mm。治疗36个月后的死亡或双肺移植率和死亡、双肺移植、再狭窄的复合率分别是5%和30%。

肺动脉高压和心绞痛患者的LMCA狭窄发生率高。CTCA在肺动脉高压和心绞痛患者的筛查中有效性较高,PCI的远期治疗效果较好。

原始出处:

DOI: 10.1016/j.jacc.2017.03.597

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    2017-12-20 hbwxf
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    2017-07-18 大旺旺

    学习了啊

    0

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    2017-06-13 ylzr123

    感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!

    0

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