Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions.
Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions.
复制标题
原发性冠状动脉病变药物涂层血管成形术后良好的血管功能。
DOI：
10.3390/jcm11020299
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发表时间：
2022-01-07
影响因子：
3.9
通讯作者：
Song WH
中科院分区：
文献类型：
--
作者：
Kim S;Lee JS;Kim YH;Kim JS;Lim SY;Kim SH;Kim M;Ahn JC;Song WH
已知球囊损伤的冠状动脉段存在异常的血管舒张。我们评估了使用药物包被球囊（DCB）治疗的新生冠状动脉病变是否容易发生血管痉挛，以及它们对麦角碱和硝酸盐的反应。在随访的132例DCB血管成形术患者中，89例患者在随访6-9个月时进行了麦角碱激发试验。在受试者中，比较了三个不同部位的人ergonovine和硝酸盐诱导的直径变化：dcb治疗、血管造影正常、血管反应性明显（痉挛）的部分。随访期间无患者出现临床难治性血管痉挛心绞痛或症状驱动型血运重建术。麦角碱诱导血管痉挛7例；所有患者均为多灶性痉挛，包括（n = 2）或保留dcb治疗的节段（n = 5）。没有显示局灶性痉挛只涉及dcb治疗的病变。在27例具有血管痉挛特征的患者中，dcb治疗的节段血管收缩小于痉挛的节段（p < 0.001）。总共分析了110例dcb治疗的病变，以评估血管舒缩功能。血管舒缩功能，定义为收缩和扩张的联合反应，在dcb治疗和血管造影正常节段之间具有可比性（p = 0.173），而在痉挛节段之间观察到显著差异（p < 0.001）。在我们的研究中，dcb治疗的病变并不特别容易发生血管痉挛，并且发现其血管舒张功能与血管造影正常节段相似，这支持了dcb治疗新发原生冠状动脉病变的安全性。
Balloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent ergonovine provocation test at 6–9 months follow-up. Within-subject ergonovine- and nitrate-induced diameter changes were compared among three different sites: DCB-treated vs. angiographically normal vs. segment showing prominent vasoreactivity (spastic). No patient experienced clinically refractory vasospastic angina or symptom-driven revascularization during follow-up. Ergonovine induced vasospasm in seven patients; all were multifocal spasm either involving (n = 2) or rather sparing DCB-treated segments (n = 5). None showed focal spasm that exclusively involved DCB-treated lesions. Among 27 patients with vasospastic features, DCB-treated segments showed less vasoconstriction than spastic counterparts (p < 0.001). A total of 110 DCB-treated lesions were analyzed to assess vasomotor function. Vasomotor function, defined as a combined constrictor and dilator response, was comparable between DCB-treated and angiographically normal segments (p = 0.173), while significant differences were observed against spastic counterparts (p < 0.001). In our study, DCB-treated lesions were not particularly vulnerable to vasospasm and were found to have vasomotor function similar to angiographically normal segments, supporting safety of DCB-only strategy in treating de novo native coronary lesions.
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影响因子：
56.9
作者：
COHEN, RA;SHEPHERD, JT;VANHOUTTE, PM
通讯作者：
VANHOUTTE, PM
DOI：
10.1016/s0735-1097(83)80327-1
发表时间：
1983-01-01
影响因子：
24
作者：
HOLLMAN, J;AUSTIN, GE;KING, SB
通讯作者：
KING, SB
影响因子：
24
作者：
Yasue, Hirofumi;Mizuno, Yuji;Saito, Yoshihiko
通讯作者：
Saito, Yoshihiko
影响因子：
37.8
作者：
LAM, JYT;CHESEBRO, JH;FUSTER, V
通讯作者：
FUSTER, V
影响因子：
37.8
作者：
FISCHELL, TA;DERBY, G;STADIUS, ML
通讯作者：
STADIUS, ML