非阻塞性冠状动脉疾病患者心肌缺血的影响因素

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Abstract Objective To investigate the related factors of myocardial ischemia in patients with non-obstructive coronary artery disease (NOCAD). Methods A total of 113 NOCAD patients who received coronary angiography or coronary computed tomography angiography with coronary artery stenosis < 50% in the Fifth Affiliated Hospital of Zhengzhou University from August 2018 to June 2020 were selected. Based on myocardial contrast echocardiography, they were divided into two groups: ischemia group (59 cases) and non-ischemia group (54 cases). Age, dyslipidemia, diabetes mellitus, hypertension, obesity, left ventricular hypertrophy, number of diseased coronary arteries, interventricular septal thickness, left ventricular mass index, and other indicators were included. Multivariate logistic regression analysis was used to explore the influencing factors of myocardial ischemia. Results More than 50% of the enrolled patients had myocardial ischemia. There were statistically significant differences in obesity, left ventricular hypertrophy, interventricular septal thickness and left ventricular mass index between two groups (P ＜ 0.05). But there were no statistically significant differences in the age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, smoking, blood glucose, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, left ventricular end diastolic dimension, left ventricular end systolic dimension, left ventricular posterior wall thickness, number of diseased coronary arteries (P ＞ 0.05). Multivariate logistic regression analysis showed that age, obesity, hypertension, dyslipidemia, number of diseased coronary arteries, diabetes mellitus, left ventricular mass index, and interventricular septal thickness were not associated with myocardial ischemia (P ＞ 0.05). Left ventricular hypertrophy was an independent risk factor for myocardial ischemia (OR ＞ 1，P ＜ 0.05). Conclusion Left ventricular hypertrophy is an independent risk factor for myocardial ischemia in NOCAD patients.

Key words： Non-obstructive coronary artery disease Myocardial ischemia Myocardial contrast echocardiography Left ventricular hypertrophy

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	DING Nan ZHANG Peisheng LIANG Xue ZHANG Pu WANG Weiping

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DING Nan ZHANG Peisheng LIANG Xue ZHANG Pu WANG Weiping. Influencing factors of myocardial ischemia in patients with non-obstructive coronary artery disease[J]. 中国医药导报, 2021, 18(23): 72-75.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I23/72

[1] Levine GN，Bates ER，Bittl JA，et al. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease [J]. Circulation，2016，134（10）：123-155.
[2] Bradley SM，Maddox TM，Stanislawski MA，et al. Normal coronary rates for elective angiography in the Veterans Affairs Healthcare System：insights from the VA CART program （veterans affairs clinical assessment reporting and tracking） [J]. J Am Coll Cardiol，2014，63（5）：417-426.
[3] Jespersen L，Hvelplund A，Abildstrom SZ，et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events [J]. Eur Heart J，2012，33（6）：734-744.
[4] Kenkre TS，Malhotra P，Johnson BD，et al. Ten-Year Mortality in the WISE Study （Women’s Ischemia Syndrome Evaluation） [J]. Circ Cardiovasc Qual Outcomes，2017，10（12）：e003863.
[5] Waheed N，Elias-Smale S，Malas W. Sex differences in non-obstructive coronary artery disease [J]. Cardiovasc Res，2020，116（4）：829-840.
[6] Herscovici R. Ischemia and no obstructive coronary artery disease（INOCA）：what is the risk? [J]. J Am Heart Assoc，2018，7（17）：e008868.
[7] Maddox TM，Stanislawski MA，Grunwald GK，et al. Non obstructive coronary artery disease and risk of myocardial infarction [J]. JAMA，2014，312（17）：1754-1763.
[8] Schulman-Marcus J，Hartaigh BO，Gransar H，et al. Sex-specific associations between coronary artery plaque extent and risk of major ad-verse cardiovascular events：the confirm long term registry [J]. JACC Cardiovasc，2016，9（4）：364-372.
[9] Gaibazzi N，Reverberi C，Lorenzoni V，et al. Prognostic value of high-dose dipyridamole stress myocardial contrast perfusion echocardiography [J]. Circulation，2012，126（10）：1217-1224.
[10] Johnson BD，Shaw LJ，Buchthal SD，et al. Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease：results from the National Institutes of Health-National Heart，Lung and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation（WISE） [J]. Circulation，2004，109（24）：2993-2999.
[11] Ford TJ，Corcoran D，Berry C. Stable coronary syndromes：pathophysiology，diagnostic advances and therapeutic need [J]，Heart，2018，104（4）：284-292.
[12] Bairey Merz CN，Pepine CJ，Walsh MN，et al. Ischemia and no obstructive coronary artery disease（INOCA）：developing evidence based therapies and research agenda for the next decade [J]. Circulation，2017，135（11）：1075-1092.
[13] Angeli F，Verdecchia P，Iacobellis G，et al. Usefulness of QRS voltage correction by body mass index to improve electrocardiographic detection of left ventricular hypertrophy inpatients with systemic hypertension [J]. Am J Cardiol，2014，114（3）：427-432.
[14] Senior R，Becher H，Monaghan M，et al. Contrast echocardiography：evidence-based recommendations by European Association of Echocardiography [J]. Eur J Echocardiogr.，2019，10（2）：194-212.
[15] Crossman DC. The pathophysiology of myocardial ischaemia [J]. Heart，2004，90（5）：576-580.
[16] Lonnebakken MT，Nordrehaug JE，Gerdts E. No gender difference in the extent of myocardial ischemia in non-ST elevation myocardial infarction [J]. Eur J Prev Cardiol，2014，21（1）：123-129.
[17] Brainin P，Frestad D，Prescott E. The prognostic value of coronary endothelial and microvascular dysfunction in subjects with normal or non-obstructive coronary artery disease：a systematic review and meta-analysis [J]. Int J Cardiol，2018，254：1-9.
[18] Marzilli M，Merz CN，Boden WE，et al. Obstructive coronary atherosclerosis and ischemic heart disease：an elusive link! [J]. J Am Coll Cardiol，2012，60（11）：951-956.
[19] Zabalgoitia M，Berning J，Koren MJ，et al. Impact of coronary artery disease on left ventricular systolic function and geometry in hypertensive patients with left ventricular hypertrophy （the LIFE study）[J]. Am J Cardiol，2001，88（6）：646-650.
[20] Nepper-Christensen L，L?覬nborg J，Ahtarovski KA，et al. Left ventricular hypertrophy is associated with increased infarct size and de-creased myocardial salvage in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention [J]. J Am Heart Assoc，2017，6（1）：e004823.
[21] Drazner MH. The Progression of hypertensive heart disease [J]. Circulation，2011，123（3）：327-334.
[22] Virtanen M，Vahtera J，Singh-Manoux A，et al. Unfavorable and favorable changes in modifiable risk factors and incidence of coronary heart disease：the Whitehall cohort study [J]. Int J Cardiol，2018，269：7-12.
[23] Task Force Members，Montalescot G，Sechtem U，et al. 2013 ESC guidelines on the management of stable coronary artery disease：the Task Force on the management of stable coronary artery disease of the European Society of Cardiology [J]. Eur Heart J，2013，34（38）：2949-3003.
[24] Stewart MH，Lavie CJ，Shah S，et al. Prognostic Implications of Left Ventricular Hypertrophy [J]. Prog Cardiovasc Dis，2018，61（5/6）：446-455.
[25] Bainey KR，Welsh RC，Alemayehu W，et al. Population level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries（MINOCA）：insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies（COAPT）study [J]. Int J Cardiol，2018，264：12-17.