Aboeata Ahmed S, Sontineni Siva P, Alla Venkata M, Esterbrooks Dennis J
Creighton University School of Medicine, Division of Cardiology, 3006 Webster Street, Omaha, NE 68131, USA.
Front Biosci (Elite Ed). 2012 Jan 1;4(1):300-10. doi: 10.2741/377.
Coronary artery ectasia (CAE) is a well-recognized angiographic finding, characterized by abnormal dilatation of the coronary arteries. We reviewed the current concepts of the condition including etiology, pathogenesis, flow alterations, clinical implications, prognosis and treatment. CAE is often viewed as a variant of obstructive coronary atherosclerosis. Exaggerated positive vascular remodeling due to inflammation, and chronic overstimulation of the endothelium by nitric oxide are potential causative mechanisms. The condition is associated with cardiovascular risk factors such as smoking and hypertension, while it appears to be inversely associated with age and diabetes mellitus. Patients with CAE typically present with angina, and are at risk for myocardial infarctions and sudden cardiac death due to slow flow, coronary vasospasm, dissection, and/or intracoronary thrombosis. CAE may be a diffuse disease associated with dilatation in other parts of the vasculature. As the incidence of this not so benign condition is expected to rise, the optimal treatment options remain undefined. Medical therapy with anticoagulants, nitrates and calcium channel blockers has been proposed and seems rational; however prospective studies with proof of efficacy are needed.
冠状动脉扩张（CAE）是一种公认的血管造影表现，其特征为冠状动脉异常扩张。我们回顾了关于该病症的当前概念，包括病因、发病机制、血流改变、临床意义、预后及治疗。CAE常被视为阻塞性冠状动脉粥样硬化的一种变体。炎症导致的过度正向血管重塑以及一氧化氮对内皮的慢性过度刺激是潜在的致病机制。该病症与吸烟和高血压等心血管危险因素相关，而似乎与年龄和糖尿病呈负相关。CAE患者通常表现为心绞痛，且因血流缓慢、冠状动脉痉挛、夹层分离和/或冠状动脉内血栓形成而有发生心肌梗死和心源性猝死的风险。CAE可能是一种与脉管系统其他部位扩张相关的弥漫性疾病。鉴于这种并非良性病症的发病率预计将会上升，最佳治疗方案仍不明确。已有人提出使用抗凝剂、硝酸盐和钙通道阻滞剂进行药物治疗，这似乎是合理的；然而需要有疗效证据的前瞻性研究。
