Coronary Microvascular Dysfunction Is Associated With a Proinflammatory Circulating Transcriptome in Patients With Nonobstructive Coronary Arteries.
Coronary Microvascular Dysfunction Is Associated With a Proinflammatory Circulating Transcriptome in Patients With Nonobstructive Coronary Arteries.
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冠状动脉微血管功能障碍与非阻塞性冠状动脉患者的促炎循环转录组相关。
DOI：
10.1161/atvbaha.123.320471
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Berger,JeffreyS
中科院分区：
文献类型：
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作者：
Smilowitz,NathanielR;Schlamp,Florencia;Hausvater,Anaïs;Joa,Amanda;Serrano-Gomez,Claudia;Farid,Ayman;Hochman,JudithS;Barrett,TessaJ;Reynolds,HarmonyR;Berger,JeffreyS
方法 根据合理要求，可从通讯作者处获得支持研究结果的去识别化数据。我们前瞻性地将接受临床指示的侵入性冠状动脉造影并伴有缺血症状、通过压力测试发现心肌缺血或两者兼而有之的女性纳入一项 CMD 的单中心诊断横断面研究（https://www.clinicaltrials.gov；唯一标识符：NCT03537586）。该研究得到了纽约大学格罗斯曼医学院机构审查委员会的批准，所有受试者在参与前都给予了知情同意。所有具有非阻塞性冠状动脉（定义为所有主要心外膜冠状动脉狭窄< 50%）的患者均被纳入。排除左心室射血分数降低< 40%、临床心力衰竭或已知肥厚性心肌病的患者。在进行指数侵入性冠状动脉造影时，使用冠状动脉热稀释技术来评估冠状动脉生理学，以测量施用腺苷（一种内皮依赖性冠状血管扩张剂）之前和之后左冠状动脉前降支的冠状动脉流量。冠状动脉血流储备（CFR）计算为通过热稀释测量的充血与基础冠状动脉流量的比率。 CMD 定义为 CFR<2.5。 1
METHODSDeidentified data that support the study findings are available from the corresponding author upon reasonable request. We prospectively enrolled women undergoing clinically indicated invasive coronary angiography with ischemic symptoms, myocardial ischemia by stress testing, or both, into a single-center diagnostic, cross-sectional study of CMD (https://www. clinicaltrials. gov; unique identifier: NCT03537586). The study was approved by the NYU Grossman School of Medicine Institutional Review Board, and all subjects gave informed consent before participation. All patients with nonobstructive coronary arteries, defined as< 50% stenosis in all major epicardial coronary arteries, were included. Patients with reduced left ventricular ejection fraction< 40%, clinical heart failure, or known hypertrophic cardiomyopathy were excluded. Coronary physiology was evaluated at the time of index invasive coronary angiography using coronary thermodilution techniques to measure coronary flow in the left anterior descending coronary artery before and after the administration of adenosine, an endothelium-independent coronary vasodilator. Coronary flow reserve (CFR) was calculated as the ratio of hyperemic to basal coronary flow measured by thermodilution. CMD was defined as a CFR< 2.5. 1