Diastolic dysfunction measured by cardiac magnetic resonance imaging in women with signs and symptoms of ischemia but no obstructive coronary artery disease.
Diastolic dysfunction measured by cardiac magnetic resonance imaging in women with signs and symptoms of ischemia but no obstructive coronary artery disease.
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通过心脏磁共振成像测量有缺血体征和症状但无阻塞性冠状动脉疾病的女性的舒张功能障碍。
DOI：
10.1016/j.ijcard.2016.06.198
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发表时间：
2016
影响因子：
3.5
通讯作者：
Merz,CNoelBairey
中科院分区：
文献类型：
--
作者：
Wei,Janet;Mehta,PujaK;Shufelt,Chrisandra;Yang,YuChing;Gill,Edward;Kahlon,Ravi;Cook-Wiens,Galen;Minissian,Margo;Kar,Saibal;Thomson,Louise;Berman,Daniel;Merz,CNoelBairey
背景：胸痛且无阻塞性冠状动脉疾病的女性常伴有冠状动脉微血管功能障碍（CMD），通过有创冠状动脉反应性试验（CRT）诊断。CMD与心脏磁共振成像（CMR）测量的舒张功能之间的关系尚不清楚。有创测量左室舒张末期压（LVEDP）、冠状动脉血流储备（CFR）和冠状动脉血流量（CBF）。对这些女性和20名对照组的静息CMR进行了左室质量、室间隔厚度、射血分数（LVEF）、舒张末期容积（EDV）、峰值充盈率（PFR）和峰值充盈率时间（tPFR）评估。结果平均年龄55 ± 9岁，LVEF ≥ 50%，LVEDP> 15mmHg者16/41（40%）。CMD（CFR <2.5或CBF <50%）存在于34/41（83%）的女性中。有或无CMD的女性tPFR（平均178 ± 110 ms）和PFR（平均3.2 ± 0.64 EDV/s）无显著差异。tPFR随年龄（r = 0.37，p = 0.017）和室间隔厚度（r = 0.47，p = 0.002）增加而增加，而PFR随年龄（r =-0.45，p =0.003）减少。CFR与tPFR呈负相关（r =-0.3，p =0.058）。增加的质量与降低的CBF相关（p = 0.02）。与对照组相比，病例有较低的LVEF（p = 0.049）和较低的EDV（p = 0.0002）。结论在妇女的症状和体征的缺血，但没有阻塞性冠状动脉疾病，CMD和LVEDP升高是普遍的。虽然非内皮依赖性CMD可能与舒张功能障碍有关，但需要进一步研究CMD、舒张功能障碍与LVEF保留的心力衰竭发展之间的联系。
BackgroundWomen with chest pain and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD), diagnosed by invasive coronary reactivity testing (CRT). The relationship between CMD and diastolic function measured by cardiac magnetic resonance imaging (CMR) is not well described.Methods41 women with suspected CMD underwent CRT and CMR. Left ventricular end-diastolic pressure (LVEDP), coronary flow reserve (CFR) and coronary blood flow (CBF) were measured invasively. Resting CMR of these women and 20 reference controls was assessed for LV mass, septal wall thickness, ejection fraction (LVEF), end-diastolic volume (EDV), peak filling rate (PFR) and time-to-peak-filling rate (tPFR). Pearson correlations and linear regression models were made.ResultsMean age was 55 ± 9, all had LVEF ≥ 50%, and 16/41 (40%) had LVEDP > 15 mm Hg. CMD (CFR < 2.5 or CBF < 50%) was present in 34/41 (83%) women. tPFR (mean 178 ± 110 ms) and PFR (mean 3.2 ± 0.64 EDV/s) were not significantly different in women with or without CMD. tPFR increased with age (r= 0.37,p= 0.017) and septal wall thickness (r= 0.47,p= 0.002), while PFR decreased with age (r= − 0.45,p= 0.003). There was an inverse relationship between CFR and tPFR (r= − 0.3,p= 0.058). Increasing mass was associated with decreasing CBF (p= 0.02). Compared to controls, cases had lower LVEF (p= 0.049) and lower EDV (p= 0.0002).ConclusionIn women with signs and symptoms of ischemia but no obstructive coronary artery disease, CMD and elevated LVEDP are prevalent. While non-endothelial dependent CMD may be related to diastolic dysfunction, further investigation is needed regarding links between CMD, diastolic dysfunction and the development of heart failure with preserved LVEF.
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DOI：
10.1186/1532-429x-12-46
发表时间：
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期刊：
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影响因子：
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作者：
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