Vojácek J
I. interní klinika Lékarské fakulty UK a FN Hradec Králové.
Vnitr Lek. 2009 Sep;55(9):827-31.
Chronic myocardial ischemia results from a temporary disbalance between supply of oxygen to myocardium and consumption of oxygen by myocardium. The most frequent cause of ischemic heart disease is atherosclerosis of the coronary arteries. At present, diagnosis of coronary impairment is for practical reasons not possible until myocardial ischemia is detectable. Despite the current pharmacological treatments, data from the recent studies justify stratification of prognosis of patients with chronic ischemic heart disease into subgroups with low, medium and high risk. Mean annual mortality is below 1% in patients with low risk, 1-2% in patients with medium risk and above 2% in patients with high risk. Revascularization procedures might improve prognosis in certain subgroups of patient with chronic ischemic heart disease. Revascularization also decreases the incidence of ischemic episodes and improves the left ventricle function in some subgroups.
慢性心肌缺血是由于心肌氧供与心肌氧耗之间暂时失衡所致。缺血性心脏病最常见的病因是冠状动脉粥样硬化。目前,由于实际原因,在心肌缺血可检测到之前,无法诊断冠状动脉损伤。尽管有目前的药物治疗,但近期研究数据表明,可将慢性缺血性心脏病患者的预后分为低、中、高风险亚组。低风险患者的年平均死亡率低于1%,中风险患者为1%-2%,高风险患者高于2%。血运重建手术可能改善某些慢性缺血性心脏病患者亚组的预后。血运重建还可降低某些亚组缺血发作的发生率,并改善左心室功能。