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冠状动脉痉挛患者201铊反向再分布与内皮功能紊乱的关系摘要研究背景:冠状动脉痉挛(coronaryarteryspasmCAS)是常见的一组临床病征,以静息性胸痛为主要表...
冠状动脉痉挛患者201铊反向再分布
与内皮功能紊乱的关系
摘 要
研究背景:冠状动脉痉挛(coronary artery spasm CAS)是常见的一组临床病征,以静息性胸痛为主要表现,可伴有心电图ST段一过性抬高。CAS不仅是变异性心绞痛的主要发病机制,而且是许多缺血性心脏病包括不稳定性心绞痛、急性心肌梗塞和心脏性猝死的重要病理生理基础之一,其机制尚不明了,研究显示可能与内血管内皮功能的紊乱、血管平滑肌舒缩功能的异常以及植物神经功能的失衡有关。目前诊断CAS主要依靠冠状动脉内激发试验,包括乙酰胆碱试验与麦角新碱试验,国内学者发现在201Tl (铊)SPECT心肌灌注显像心脏负荷试验中呈反向再分布(reverse redistribution RR)现象是CAS患者的特点之一,若结合运动心电图试验阴性以及静息性胸痛的临床特点,诊断冠冠状动脉痉挛的灵敏度以及特意度分别可以达到98%和90%。但是反向再分布的临床意义目前还存在争议,本文旨在通过比较患者心肌灌注显像负荷试验前后血浆ET-1、NO含量以及ET-1/NO水平的变化来进一步探讨反向再分布与血管内皮功能的关系。
目的:探讨冠状动脉痉挛(CAS)患者在201Tl(铊)SPECT心肌灌注显像心脏负荷试验中呈反向再分布(RR)现象与血管内皮功能的关系。 展开
与内皮功能紊乱的关系
摘 要
研究背景:冠状动脉痉挛(coronary artery spasm CAS)是常见的一组临床病征,以静息性胸痛为主要表现,可伴有心电图ST段一过性抬高。CAS不仅是变异性心绞痛的主要发病机制,而且是许多缺血性心脏病包括不稳定性心绞痛、急性心肌梗塞和心脏性猝死的重要病理生理基础之一,其机制尚不明了,研究显示可能与内血管内皮功能的紊乱、血管平滑肌舒缩功能的异常以及植物神经功能的失衡有关。目前诊断CAS主要依靠冠状动脉内激发试验,包括乙酰胆碱试验与麦角新碱试验,国内学者发现在201Tl (铊)SPECT心肌灌注显像心脏负荷试验中呈反向再分布(reverse redistribution RR)现象是CAS患者的特点之一,若结合运动心电图试验阴性以及静息性胸痛的临床特点,诊断冠冠状动脉痉挛的灵敏度以及特意度分别可以达到98%和90%。但是反向再分布的临床意义目前还存在争议,本文旨在通过比较患者心肌灌注显像负荷试验前后血浆ET-1、NO含量以及ET-1/NO水平的变化来进一步探讨反向再分布与血管内皮功能的关系。
目的:探讨冠状动脉痉挛(CAS)患者在201Tl(铊)SPECT心肌灌注显像心脏负荷试验中呈反向再分布(RR)现象与血管内皮功能的关系。 展开
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Abstract
Background: Coronary artery spasm (coronary artery spasm CAS) is a common clinical symptoms of a group to rest as the main performance of chest pain, ECG can be accompanied by transient ST-elevation. CAS is not only the variability of the main pathogenesis of angina pectoris and ischemic heart disease for many, including unstable angina, acute myocardial infarction and sudden cardiac death of one of the foundations of an important pathophysiological mechanism is not yet clear, studies have shown may be related to vascular endothelial function disorders, vascular smooth muscle, and abnormal systolic and diastolic function of the imbalance of the autonomic function. CAS is currently rely mainly on the diagnosis of coronary provocation test, including acetylcholine and ergonovine test pilot, domestic scholars have found in 201Tl (Tl) SPECT myocardial perfusion imaging in the cardiac stress test was reverse redistribution (reverse redistribution RR) is CAS One of the characteristics of patients, if the combination of exercise electrocardiography test negative as well as the rest of the clinical features of chest pain, diagnosis of coronary artery spasm highest sensitivity and can be made respectively 98% and 90% respectively. But the reverse redistribution of the clinical significance is still controversial, this article aims to compare patients with myocardial perfusion imaging stress test before and after the plasma ET-1, NO content, as well as changes in the level of ET-1/NO to further explore the re-distribution of the reverse the relationship between vascular endothelial function.
Objective: To evaluate the coronary artery spasm (CAS) in patients with 201Tl (Tl) SPECT myocardial perfusion imaging in the cardiac stress test was reverse redistribution (RR) phenomenon and the relationship between vascular endothelial function.
Background: Coronary artery spasm (coronary artery spasm CAS) is a common clinical symptoms of a group to rest as the main performance of chest pain, ECG can be accompanied by transient ST-elevation. CAS is not only the variability of the main pathogenesis of angina pectoris and ischemic heart disease for many, including unstable angina, acute myocardial infarction and sudden cardiac death of one of the foundations of an important pathophysiological mechanism is not yet clear, studies have shown may be related to vascular endothelial function disorders, vascular smooth muscle, and abnormal systolic and diastolic function of the imbalance of the autonomic function. CAS is currently rely mainly on the diagnosis of coronary provocation test, including acetylcholine and ergonovine test pilot, domestic scholars have found in 201Tl (Tl) SPECT myocardial perfusion imaging in the cardiac stress test was reverse redistribution (reverse redistribution RR) is CAS One of the characteristics of patients, if the combination of exercise electrocardiography test negative as well as the rest of the clinical features of chest pain, diagnosis of coronary artery spasm highest sensitivity and can be made respectively 98% and 90% respectively. But the reverse redistribution of the clinical significance is still controversial, this article aims to compare patients with myocardial perfusion imaging stress test before and after the plasma ET-1, NO content, as well as changes in the level of ET-1/NO to further explore the re-distribution of the reverse the relationship between vascular endothelial function.
Objective: To evaluate the coronary artery spasm (CAS) in patients with 201Tl (Tl) SPECT myocardial perfusion imaging in the cardiac stress test was reverse redistribution (RR) phenomenon and the relationship between vascular endothelial function.
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