Coronary microembolization
Coronary microembolization
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DOI：
10.1016/j.yjmcc.2004.04.011
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发表时间：
2004-07-01
影响因子：
5
通讯作者：
Erbel, R
中科院分区：
文献类型：
--
作者：
Heusch, G;Schulz, R;Erbel, R
动脉粥样硬化斑块破裂是急性冠状动脉综合征发病机制和冠状动脉介入治疗过程中的关键事件。动脉粥样硬化斑块破裂并不总是导致整个心外膜冠状动脉的完全血栓性闭塞，随后发生急性心肌梗死，但可能以较轻的形式导致动脉粥样硬化和血栓性碎片栓塞到冠状动脉微循环中。这篇综述总结了冠状动脉微栓塞在死于冠状动脉疾病，特别是猝死患者中的形态学证据。然后详细介绍了急性冠状动脉综合征动物模型中冠状动脉微栓塞的实验病理生理。最后，审查提出了现有的临床证据冠状动脉微栓塞的患者，突出了其关键特征心律失常，收缩功能障碍，微梗死和冠状动脉储备减少，比较这些功能的实验模型，并解决其预防机械保护装置和糖蛋白IIb/IIIa拮抗作用。(C)2004爱思唯尔有限公司保留所有权利。
Atherosclerotic plaque rupture is a key event in the pathogenesis of acute coronary syndromes and during coronary interventions. Atherosclerotic plaque rupture does not always result in complete thrombotic occlusion of the entire epicardial coronary artery with subsequent acute myocardial infarction, but may in milder forms result in the embolization of atherosclerotic and thrombotic debris into the coronary microcirculation. This review summarizes the available morphological evidence for coronary microembolization in patients who died from coronary artery disease, most notably from sudden death. Then the experimental pathophysiology of coronary microembolization in animal models of acute coronary syndromes is detailed. Finally, the review presents the available clinical evidence for coronary microembolization in patients, highlights its key features-arrhythmias, contractile dysfunction, microinfarcts and reduced coronary reserve-, compares these features to those of the experimental model and addresses its prevention by mechanical protection devices and glycoprotein IIb/IIIa antagonism. (C) 2004 Elsevier Ltd. All rights reserved.