Vasodilator Strain Stress Echocardiography in Suspected Coronary Microvascular Angina.
Vasodilator Strain Stress Echocardiography in Suspected Coronary Microvascular Angina.
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DOI：
10.3390/jcm11030711
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发表时间：
2022-01-28
影响因子：
3.9
通讯作者：
On Behalf Of The Stress Echo Study Group Of The Italian Society Of Echocardiography And Cardiovascular Imaging Siecvi
中科院分区：
文献类型：
--
作者：
Rodriguez-Zanella H;Arbucci R;Fritche-Salazar JF;Ortiz-Leon XA;Tuttolomondo D;Lowenstein DH;Wierzbowska-Drabik K;Ciampi Q;Kasprzak JD;Gaibazzi N;Lowenstein J;Posada-Martinez EL;Arias-Godinez JA;de la Fuente-Mancera JC;Picano E;On Behalf Of The Stress Echo Study Group Of The Italian Society Of Echocardiography And Cardiovascular Imaging Siecvi
背景：在缺血和非阻塞性冠状动脉狭窄（INOCA）患者中，壁运动在应激超声心动图（SE）中很少异常。我们的目的是通过二维斑点跟踪超声心动图（2DSTE）确定在SE期间，是否有INOCA和冠状动脉血流速度储备（CVFR）降低的患者改变了心脏力学。方法：在一项前瞻性、多中心、国际研究中，我们招募了135例INOCA患者。总体而言，我们采用高剂量（0.84 mg/kg）双嘧达莫SE，并联合评估CVFR和2DSTE。将患者分为CVFR正常组（>2，组1，n = 95）和CVFR异常组（≤2，组2，n = 35）。两组间临床及2DSTE参数比较。结果：CFVR（98%）和2DSTE（97%）的可行性高。共有130例患者（平均年龄63±12岁，67例女性）有完整的血流和应变数据。两组在休息时的2DSTE值相似。在SE峰值，1组患者整体纵向应变较低（p < 0.007），机械离散度较高（p < 0.0005），心内膜层特异应变较低（p < 0.001），心外膜层特异应变较低（p < 0.0002）。结论：在INOCA患者中，血管扩张剂SE同时评估CFVR和应变是高度可行的。冠状动脉微血管功能障碍伴随着应力作用下整体和层特异性变形指标的损害。
Background: In patients with Ischemia and non-obstructive coronary artery stenosis (INOCA) wall motion is rarely abnormal during stress echocardiography (SE). Our aim was to determine if patients with INOCA and reduced coronary flow velocity reserve (CVFR) have altered cardiac mechanics using two-dimensional speckle-tracking echocardiography (2DSTE) during SE. Methods: In a prospective, multicenter, international study, we recruited 135 patients with INOCA. Overall, we performed high dose (0.84 mg/kg) dipyridamole SE with combined assessment of CVFR and 2DSTE. The population was divided in patients with normal CVFR (>2, group 1, n = 95) and abnormal CVFR (≤2, group 2, n = 35). Clinical and 2DSTE parameters were compared between groups. Results: Feasibility was high for CFVR (98%) and 2DSTE (97%). A total of 130 patients (mean age 63 ± 12 years, 67 women) had complete flow and strain data. The two groups showed similar 2DSTE values at rest. At peak SE, Group 1 patients showed lower global longitudinal strain (p < 0.007), higher mechanical dispersion (p < 0.0005), lower endocardial (p < 0.001), and epicardial (p < 0.0002) layer specific strain. Conclusions: In patients with INOCA, vasodilator SE with simultaneous assessment of CFVR and strain is highly feasible. Coronary microvascular dysfunction is accompanied by an impairment of global and layer-specific deformation indices during stress.
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影响因子：
39.3
作者：
Hanekom, Lizelle;Cho, Goo-Yeong;Marwick, Thomas H.
通讯作者：
Marwick, Thomas H.
影响因子：
2.8
作者：
Cortigiani, Lauro;Carpeggiani, Clara;Picano, Eugenio
通讯作者：
Picano, Eugenio
影响因子：
39.3
作者：
Ciampi Q;Zagatina A;Cortigiani L;Wierzbowska-Drabik K;Kasprzak JD;Haberka M;Djordjevic-Dikic A;Beleslin B;Boshchenko A;Ryabova T;Gaibazzi N;Rigo F;Dodi C;Simova I;Samardjieva M;Barbieri A;Morrone D;Lorenzoni V;Prota C;Villari B;Antonini-Canterin F;Pepi M;Carpeggiani C;Pellikka PA;Picano E
通讯作者：
Picano E
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
24
作者：
Ciampi, Quirino;Zagatina, Angela;Picano, Eugenio
通讯作者：
Picano, Eugenio