保留射血分数（WISE Pre-HFpEF）的女性冠状动脉微血管功能障碍导致心衰前期的缺血综合征评估机制的基本原理和设计。

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2025-02-24 DOI:10.1016/j.ahj.2025.02.017

Tatsunori Takahashi MD , Janet Wei MD , Ana C. Iribarren MD , Martha Gulati MD MS , Galen Cook-Wiens MS , Michael D. Nelson PhD , Behzad Sharif PhD , Eileen M. Handberg PhD , R. David Anderson MD , John Petersen MD , Daniel S. Berman MD , Carl J. Pepine MD , C. Noel Bairey Merz MD

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引用次数: 0

摘要

背景：越来越多的人认识到冠状动脉微血管功能障碍（CMD）的病理生理在保留射血分数（HFpEF）心力衰竭的发展中起着关键作用。然而，这种作用背后的机制尚不清楚。研究设计和方法：女性缺血综合征评估冠状动脉微血管功能障碍导致心力衰竭前射血分数保留的机制（WISE Pre-HFpEF）是一项前瞻性队列研究，纳入180名女性和男性，接受临床指示的有创冠状动脉造影，诊断疑似缺血，无阻塞性冠状动脉疾病。本研究旨在研究(i)在等距握力刺激应激试验中，通过冠状窦/心大静脉和左室压力-容量环的超敏感心肌肌钙蛋白i （u-hs-cTnI）测量，有创性地确定了cmd相关缺血对心肌细胞损伤和左室舒张受损的贡献；（ii）通过入组时和1-2年后获得的心脏磁共振成像，以及前瞻性重复的u-hs-cTnI测量，评估cd相关的缺血性心肌细胞损伤对左室舒张功能障碍进展的影响。结论：WISE hfpef前研究旨在研究CMD继发缺血性心肌损伤是否有助于左室舒张功能障碍的进展。这项研究的结果将为CMD在HFpEF发展中的作用以及CMD导向疗法预防和治疗HFpEF的潜在益处提供新的认识。试验注册：clinicaltrial .gov, NCT03876223。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

$Rationale and design of the women's ischemia syndrome evaluation mechanisms of coronary microvascular dysfunction leading to preheart failure with preserved ejection fraction (WISE Pre-HFPEF)$

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Rationale and design of the women's ischemia syndrome evaluation mechanisms of coronary microvascular dysfunction leading to preheart failure with preserved ejection fraction (WISE Pre-HFPEF)

Background

There is increasing recognition that the pathophysiology of coronary microvascular dysfunction (CMD) plays a pivotal role in the development of heart failure with preserved ejection fraction (HFpEF). However, the mechanisms underlying this role are not known.

Study design and methods

The Women's Ischemia Syndrome Evaluation Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-Heart Failure With Preserved Ejection Fraction (WISE Pre-HFpEF) is a prospective cohort study enrolling 180 women and men undergoing clinically indicated invasive coronary angiography for suspected ischemia with no obstructive coronary artery disease. The study aims to investigate (1) CMD-related ischemia contribution to myocellular damage and impaired left ventricular (LV) relaxation as determined invasively by ultra-high sensitivity cardiac troponin I (u-hs-cTnI) measurements in the coronary sinus/great cardiac vein and LV pressure-volume loops, respectively, during provocative stress testing with isometric handgrip, and (2) CMD-related ischemic myocellular damage contribution to LV diastolic dysfunction progression as assessed using cardiac magnetic resonance imaging obtained at enrollment and 1-2 years later, along with prospectively repeated ambulatory u-hs-cTnI measurements.

Conclusions

The WISE pre-HFpEF study is designed to investigate whether ischemic myocardial damage secondary to CMD contributes to the progression of LV diastolic dysfunction. The findings from this study will provide new understanding of the role of CMD in HFpEF development as well as the potential benefits of CMD-directed therapies for the prevention and treatment of HFpEF.

Trial registration

ClilicalTrial.gov, NCT03876223

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来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.