冠状窦狭窄缓解心肌缺血和改善心绞痛的原理。

IF 2.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Megha Prasad, Maayan Konigstein, Ranil de-Silva, Amir Lerman, Shmuel Banai
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引用次数: 0

摘要

对难治性心绞痛患者的有效治疗仍然是一个主要的未满足的需求。慢性心绞痛对医学和介入治疗都是难治性的,主要影响不适合血管重建术的患者、血管重建术成功后的患者以及冠状动脉微血管功能障碍的患者。冠状静脉窦(CS)狭窄作为治疗心绞痛的一种潜在方法已被研究。临床前和临床数据,包括两项随机假对照临床试验和两项大型前瞻性多中心注册,证实了CS变窄治疗梗阻性冠状动脉疾病(CAD)难治性心绞痛的安全性和有效性。初步病理生理研究表明,冠状动脉狭窄也可能改善冠状动脉微血管功能,减轻微血管心绞痛。在此,我们回顾了CS变窄的历史观点、作用机制和临床应用。结论:随着新数据的积累,现在是时候重新审视历史上CS干预所带来的治疗益处,并在最近的临床研究中证明可以减少心绞痛和缺血,提高致残性难治性心绞痛患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Principles of Coronary Sinus Narrowing to Relieve Myocardial Ischemia and Improve Angina.

Effective therapy for patients suffering from refractory angina remains a major unmet need. Chronic angina, which is refractory to medical and interventional therapies, affects patients who are not suitable for revascularization, patients following successful revascularization, and patients with coronary microvascular dysfunction. Coronary sinus (CS) narrowing has been studied as a potential therapy for patients with angina. Pre-clinical and clinical data, including 2 randomized sham-controlled clinical trials and 2 large prospective multi-center registries, have confirmed the safety and effectiveness of CS narrowing in patients with refractory angina due to obstructive coronary artery disease (CAD). Preliminary pathophysiologic studies suggest that CS narrowing may also improve coronary microvascular function and alleviate microvascular angina. Here, we review the historical perspective, mechanism of action, and clinical applications of CS narrowing. In Conclusion: With the accumulation of new data, the time is ripe to revisit the therapeutic benefits seen in historical CS interventions and demonstrated in recent clinical research to reduce angina and ischemia and improve quality of life of patients with disabling refractory angina.

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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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