A Review of the Role of Tests of Coronary Reactivity in Clinical Practice.

European cardiology Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI:10.15420/ecr.2022.12
Shozo Sueda, Tomoki Sakaue
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Abstract

Vasoreactivity testing is used by cardiologists in the diagnosis of coronary spasm endotypes, such as epicardial and microvascular spasm. Intracoronary injection of acetylcholine and ergonovine is defined as a standard class I method according to the Coronary Vasomotion Disorder (COVADIS) Group. Because single vasoreactivity testing may have some clinical limitations in detecting the presence of coronary spasm, supplementary or sequential vasoreactivity testing should be reconsidered. The majority of cardiologists do not consider pseudonegative results when performing these vasoreactivity tests. Vasoreactivity testing may have some limitations when it comes to documenting clinical spasm. In the future, cardiologists around the world should use multiple vasoreactivity tests to verify the presence or absence of epicardial and microvascular spasms in the cardiac catheterisation laboratory.

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冠状动脉反应性测试在临床实践中的作用回顾。
血管活性测试被心脏病专家用于诊断冠状动脉痉挛内型,如心外膜和微血管痉挛。根据冠状动脉血管运动障碍(COVADIS)小组的定义,冠状动脉内注射乙酰胆碱和麦角新碱是标准的一级方法。由于单一血管反应性检测在发现冠状动脉痉挛方面可能存在一些临床局限性,因此应重新考虑辅助性或顺序性血管反应性检测。大多数心脏病专家在进行这些血管反应性检测时不会考虑假阴性结果。在记录临床痉挛时,血管反应性检测可能存在一些局限性。今后,世界各地的心脏病专家应在心导管实验室使用多种血管反应性测试来验证心外膜和微血管痉挛的存在与否。
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