Gori Tommaso, Anadol Remzi
Kardiologie I, Zentrum für Kardiologie, University Medical Center Mainz and DZHK standort Rhein-Main, Germany.
Clin Hemorheol Microcirc. 2018;70(4):375-379. doi: 10.3233/CH-189302.
Up to 50% of the patients undergoing coronary angiography present no epicardial disease. Most of these patients are women. Takotsubo cardiomyopathy, coronary microvascular dysfunction, and spontaneous coronary artery dissection are the most common syndromes that affect these patients. Their mechanisms are complex, with a interplay between neurohormonal factors and a number of other systems. The present review describes how changes in the estrogen state may lead to changes in vasomotor tone and endothelial dysfunction which result in coronary epicardial and microvascular spasm and coronary arterial wall instability in these three conditions. The sex-dependent differences in prevalence, pathogenesis, and prognosis are described.
接受冠状动脉造影的患者中，高达50%没有心外膜疾病。这些患者大多数是女性。应激性心肌病、冠状动脉微血管功能障碍和自发性冠状动脉夹层是影响这些患者的最常见综合征。它们的机制很复杂，涉及神经激素因素和许多其他系统之间的相互作用。本综述描述了雌激素状态的变化如何导致血管运动张力和内皮功能障碍的改变，进而在这三种情况下导致冠状动脉心外膜和微血管痉挛以及冠状动脉壁不稳定。文中还描述了在患病率、发病机制和预后方面的性别差异。
