In women with symptoms of cardiac ischemia, nonobstructive coronary arteries, and microvascular dysfunction, angiotensin-converting enzyme inhibition is associated with improved microvascular function: A double-blind randomized study from the National Heart, Lung and Blood Institute Women's Ischemia Syndrome Evaluation (WISE).
In women with symptoms of cardiac ischemia, nonobstructive coronary arteries, and microvascular dysfunction, angiotensin-converting enzyme inhibition is associated with improved microvascular function: A double-blind randomized study from the National Heart, Lung and Blood Institute Women's Ischemia Syndrome Evaluation (WISE).
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在患有心脏缺血症状的女性中，非刺发生性冠状动脉和微血管功能障碍，血管紧张素转换酶抑制与改善的微血管功能有关：一项来自国家心脏，肺和血液研究所女性缺血症（明智）的双盲随机研究。
DOI：
10.1016/j.ahj.2011.07.011
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发表时间：
2011-10
影响因子：
4.8
通讯作者：
Pepine, Carl J.
中科院分区：
文献类型：
--
作者：
Pauly, Daniel F.;Johnson, B. Delia;Anderson, R. David;Handberg, Eileen M.;Smith, Karen M.;Cooper-DeHoff, Rhonda M.;Sopko, George;Sharaf, Barry M.;Kelsey, Sheryl F.;Merz, C. Noel Bairey;Pepine, Carl J.
我们研究了肾素-血管紧张素系统在无阻塞性冠状动脉疾病（CAD）的女性缺血体征和症状中的作用。虽然微血管功能障碍被认为可以解释这种综合征，最近发现可以预测不良结局，但其机制和治疗方法仍不清楚。在女性缺血综合征评估的一项子研究中，78名患有微血管功能障碍（腺苷治疗后冠状动脉血流储备[CFR] <3.0）且无阻塞性CAD的女性被随机分配到血管紧张素转换酶抑制剂（ACE-I）与喹那普利或安慰剂治疗组。主要疗效参数为根据基线特征和临床试验机构调整的第16周时的CFR。次要反应变量是使用西雅图心绞痛问卷评估的无心绞痛症状。共有61名妇女完成了16周的治疗期，重复测量CFR，治疗耐受性良好。对于主要结果，在16周时，ACE-I组的CFR改善程度高于安慰剂组（p<0.02）。对于症状改善的次要结局，ACE-I治疗（p=0.037）和CFR增加（p=0.008）均起作用。ACE-I治疗可改善有缺血体征和症状但无阻塞性CAD的女性患者的微血管功能。这种改善与心绞痛的减少有关。冠状动脉微血管系统的有益反应仅限于基线CFR值较低的女性，这表明肾素-血管紧张素系统可能更多地参与了更严重的微血管缺陷的女性。
We investigated the role of the renin-angiotensin system in women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). Although microvascular dysfunction has been suggested to explain this syndrome and recently was found to predict adverse outcomes, the mechanisms and treatments remain unclear. In a substudy within the Women’s Ischemia Syndrome Evaluation, 78 women with microvascular dysfunction (coronary flow reserve [CFR] <3.0 following adenosine) and no obstructive CAD were randomly assigned to either an angiotensin-converting enzyme inhibition (ACE-I) with quinapril or a placebo treatment group. The primary efficacy parameter was CFR at 16 weeks adjusted for baseline characteristics and clinical site. The secondary response variable was freedom from angina symptoms assessed using the Seattle Angina Questionnaire. A total of 61 women completed the 16-week treatment period with repeat CFR measurements, and treatment was well tolerated. For the primary outcome, at 16 weeks CFR improved more with ACE-I than placebo (p<0.02). For the secondary outcome of symptom improvement, ACE-I treatment (p=0.037) and CFR increase (p=0.008) both contributed. Microvascular function improves with ACE-I therapy in women with signs and symptoms of ischemia without obstructive CAD. This improvement is associated with reduction in angina. The beneficial response of the coronary microvasculature was limited to women with lower baseline CFR values, suggesting that the renin-angiotensin system may be more involved among women with more severe microvascular defects.
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影响因子：
2.8
作者：
Chen, JW;Hsu, NW;Chang, MS
通讯作者：
Chang, MS
DOI：
10.1016/s0735-1097(99)00537-9
发表时间：
2000-01-01
影响因子：
24
作者：
Anderson, TJ;Elstein, E;Charbonneau, F
通讯作者：
Charbonneau, F
影响因子：
158.5
作者：
Panting, JR;Gatehouse, PD;Pennell, DJ
通讯作者：
Pennell, DJ
影响因子：
39.3
作者：
Johnson, B. Delia;Shaw, Leslee J.;Merz, C. Noel Bairey
通讯作者：
Merz, C. Noel Bairey
影响因子：
37.8
作者：
Antony, I;Lerebours, G;Nitenberg, A
通讯作者：
Nitenberg, A