原发性微血管心绞痛冠状动脉微循环功能障碍的影像学研究进展  

Advances in imaging study of coronary microcirculatory dysfunction in patients with primary microvascular angina

作　　者：朱艳艳 丁明岩 冀威 张慧慧[1] 李颖[1] 赵含章[1] 邵圆 李雪[2] 朱芳[1] ZHU Yanyan;DING Mingyan;JI Wei;ZHANG Huihui;LI Ying;ZHAO Hanzhang;SHAO Yuan;LI Xue;ZHU Fang(Department of Cardiac Function,People’s Hospital of China Medical University,Shenyang,110016,China;Department of Nuclear Medicine,People’s Hospital of China Medical University)

机构地区：[1]中国医科大学人民医院心功能科,沈阳110016 [2]中国医科大学人民医院核医学科

出　　处：《临床心血管病杂志》2021年第1期7-12,共6页Journal of Clinical Cardiology

基　　金：辽宁省科学技术计划基金项目(No:20180530109)。

摘　　要：原发性微血管心绞痛(MVA)通常是有典型心绞痛症状,但血管造影检查显示冠状动脉(冠脉)正常。由于无法通过血管造影术评估小冠脉,因此在临床实践中,通常排除其他可能的心源性和非心源性心脏病后,才对原发性MVA进行诊断。原发性MVA患病率较高,后期生活质量较差,心脏死亡风险较高。所以要早期发现原发性MVA,并尽早干预。要明确诊断原发性MVA,就需要有冠脉微循环功能障碍(CMD)的证据。目前诊断方法有侵入性方法(如冠脉内多普勒导线和热稀释)和非侵入性方法(如PET、心脏MRI、经胸多普勒超声心动图检查)。但侵入性方法存在风险,而且不能广泛应用于临床。非侵入性方法可以用于量化冠脉血流和了解微血管功能障碍,并且得到临床研究证实。Primary microvascular angina(MVA)usually has typical angina symptoms,but angiography shows that the coronary arteries are normal.Since small coronary arteries cannot be evaluated by angiography,primary MVA is usually diagnosed after other possible cardiogenic and non-cardiogenic heart diseases are excluded in clinical practice.The prevalence rate of primary MVA is higher,the quality of life is poor,and the risk of cardiac death is higher.Therefore,it is necessary to find primary MVA,early and intervene as soon as possible.Evidence of coronary artery microvascular dysfunction(CMD)is necessary for the diagnosis of primary MVA.Current diagnostic methods include invasive methods(such as Intracoronary Doppler leads and thermodilution)and non-invasive methods(such as PET,heart MRI,Transthoracic Doppler echocardiography).However,invasive methods are risky and can not be widely used in the clinic.Non-invasive methods can quantify coronary blood flow and understand microvascular dysfunction and have been proved by clinical studies.

关 键 词：冠状动脉微血管功能障碍 微血管心绞痛 影像学检查 

分 类 号：R541.4[医药卫生—心血管疾病]