Coronary Microvascular Dysfunction Is Associated With Myocardial Ischemia and Abnormal Coronary Perfusion During Exercise
Coronary Microvascular Dysfunction Is Associated With Myocardial Ischemia and Abnormal Coronary Perfusion During Exercise
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冠状动脉微血管功能障碍与运动时心肌缺血和冠状动脉灌注异常有关
DOI：
10.1161/circulationaha.119.041595
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发表时间：
2019-11-26
期刊：
影响因子：
37.8
通讯作者：
Perera, Divaka
中科院分区：
文献类型：
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作者：
Rahman, Haseeb;Ryan, Matthew;Perera, Divaka
背景技术背景：冠状动脉微血管功能障碍（MVD）是指在非阻塞性冠状动脉疾病的情况下，对药理学血管扩张剂的血流增强反应受损。目前还不清楚是否减少冠状动脉血管舒张反应与异常运动生理学或诱导心肌ischemia.METHODS：心绞痛和非阻塞性冠状动脉疾病患者同时冠状动脉压力和流速测量使用双传感器尖端导丝在休息，仰卧自行车运动，和腺苷介导的充血。微血管阻力（MR）计算为冠状动脉压力除以流速。波强度分析量化了加速波能量的比例（灌注效率）。在充血和静息状态下，使用3-T心脏磁共振成像量化整体心肌血流量和内膜下：心外膜下灌注比;诱导性缺血定义为充血内膜下：心外膜下灌注比
BACKGROUND: Coronary microvascular dysfunction (MVD) is defined by impaired flow augmentation in response to a pharmacological vasodilator in the presence of nonobstructive coronary artery disease. It is unknown whether diminished coronary vasodilator response correlates with abnormal exercise physiology or inducible myocardial ischemia.METHODS: Patients with angina and nonobstructive coronary artery disease had simultaneous coronary pressure and flow velocity measured using a dual sensor-tipped guidewire during rest, supine bicycle exercise, and adenosine-mediated hyperemia. Microvascular resistance (MR) was calculated as coronary pressure divided by flow velocity. Wave intensity analysis quantified the proportion of accelerating wave energy (perfusion efficiency). Global myocardial blood flow and subendocardial:subepicardial perfusion ratio were quantified using 3-Tesla cardiac magnetic resonance imaging during hyperemia and rest; inducible ischemia was defined as hyperemic subendocardial:subepicardial perfusion ratio