“原发性”微血管性心绞痛：临床特征、发病机制与治疗
'Primary' Microvascular Angina: Clinical Characteristics, Pathogenesis and Management.
作者信息
Lanza Gaetano Antonio, De Vita Antonio, Kaski Juan-Carlos
机构信息
Institute of Cardiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli Rome, Italy.
Molecular and Clinical Sciences Research Institute, St George's, University of London London, UK.
出版信息
Interv Cardiol. 2018 Sep;13(3):108-111. doi: 10.15420/icr.2018.15.2.
Microvascular angina (MVA), i.e. angina caused by abnormalities of the coronary microcirculation, is increasingly recognised in clinical practice. The pathogenetic mechanisms of MVA are heterogeneous and may involve both structural and functional alterations of coronary microcirculation, and functional abnormalities may variably involve an impairment of coronary microvascular dilatation and an increased microvascular constrictor activity. Both invasive and non-invasive diagnostic tools exist to identify patients with MVA in clinical practice. Prognosis has been reported to be good in primary MVA patients, although the prognostic implications of coronary microvascular dysfunction (CMVD) in more heterogeneous populations of angina patients need further assessment. Management of primary MVA can be challenging, but pharmacological and non-pharmacological treatments exist that allow satisfactory control of symptoms in most patients.
微血管性心绞痛（MVA），即由冠状动脉微循环异常引起的心绞痛，在临床实践中越来越受到认可。MVA的发病机制是异质性的，可能涉及冠状动脉微循环的结构和功能改变，功能异常可能不同程度地涉及冠状动脉微血管扩张受损和微血管收缩活性增加。在临床实践中，有有创和无创诊断工具可用于识别MVA患者。据报道，原发性MVA患者的预后良好，尽管冠状动脉微血管功能障碍（CMVD）在更异质性的心绞痛患者群体中的预后意义需要进一步评估。原发性MVA的管理可能具有挑战性，但存在药物和非药物治疗方法，可使大多数患者的症状得到满意控制。
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