Lim Tiong K, Choy AnnaMaria J, Khan Faisel, Belch Jill J F, Struthers Allan D, Lang Chim C
Division of Medicine and Therapeutics, University of Dundee, Dundee, UK.
Cardiovasc Ther. 2009 Spring;27(1):49-58. doi: 10.1111/j.1755-5922.2008.00070.x.
Morbidity of patients with cardiac syndrome X (typical anginal-like chest pain and normal coronary arteriogram) is high with continuing episodes of chest pain and frequent hospital readmissions. Management of this syndrome represents a major challenge for the treating physician. Conventional therapies with antianginal agents such as nitrates, calcium channel antagonists, classic beta-adrenoceptor blockers and nicorandil have been tried, with variable success. However, this might be related to a failure to target the underlying pathophysiology and, clearly, more effective therapies are needed. Supporting evidence for the important role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X has come from the recent observation that basal superoxide production predicts future cardiovascular events in this patient group. This review will discuss the pathophysiology, current medical management and potential new pharmacological treatment for patients with cardiac syndrome X which target endothelial dysfunction and oxidative stress. What's already known about this topic? Morbidity of patients with cardiac syndrome X is high. The important role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X. What does this article add? This review will discuss the pathophysiology, current medical management and potential new pharmacological treatment for patients with cardiac syndrome X which target endothelial dysfunction and oxidative stress.
心脏X综合征（典型的心绞痛样胸痛且冠状动脉造影正常）患者的发病率较高，胸痛持续发作且频繁住院。对该综合征的管理对治疗医生来说是一项重大挑战。已经尝试了使用抗心绞痛药物如硝酸盐、钙通道拮抗剂、经典β肾上腺素能受体阻滞剂和尼可地尔进行常规治疗，但效果不一。然而，这可能与未能针对潜在的病理生理学有关，显然，需要更有效的治疗方法。内皮功能障碍和氧化应激在心脏X综合征发病机制中的重要作用的支持证据来自最近的观察结果，即基础超氧化物生成可预测该患者群体未来的心血管事件。本综述将讨论针对内皮功能障碍和氧化应激的心脏X综合征患者的病理生理学、当前医学管理及潜在的新药治疗。关于这个主题已知的内容有哪些？心脏X综合征患者的发病率较高。内皮功能障碍和氧化应激在心脏X综合征发病机制中的重要作用。本文补充了什么内容？本综述将讨论针对内皮功能障碍和氧化应激的心脏X综合征患者的病理生理学、当前医学管理及潜在的新药治疗。
