非阻塞性冠状动脉疾病伴心肌缺血或梗死患者的血管内皮功能障碍。

Endothelial dysfunction in patients with myocardial ischemia or infarction and nonobstructive coronary arteries.

机构信息

Department of Cardiology, Tepecik Training and Research Hospital, University of Health Science, Izmir, Turkey.

Department of Biochemistry, Tepecik Training and Research Hospital, University of Health Science, Izmir, Turkey.

出版信息

J Clin Ultrasound. 2021 May;49(4):334-340. doi: 10.1002/jcu.22902. Epub 2020 Aug 9.

DOI:10.1002/jcu.22902

PMID:32776332

Abstract

PURPOSE

The syndromes of myocardial infarction/myocardial ischemia with No Obstructive Coronary Artery Disease (MINOCA/INOCA) are seen more and more often. Endothelial dysfunction (ED) leading to ischemic events has been reported in many of these patients. We aimed to compare patients with MINOCA and INOCA regarding brachial artery flow-mediated endothelium-dependent vasodilation (flow-mediated dilation [FMD]) and plasma concentration of cardiotrophin-1 (CT-1).

METHODS

We included 42 patients with MINOCA and 38 patients with INOCA. Endothelial function was assessed by measuring FMD% and nitroglycerin-mediated dilatation (NMD%) in the brachial artery. The plasma level of CT-1 was determined by solid-phase enzyme-linked immunosorbent assay.

RESULTS

FMD% was significantly lower in MINOCA than in INOCA patients (6.45 ± 2.65 vs 8.94 ± 3.32, P < .001), without significant difference in NMD% (10.69 ± 3.19 vs 12.16 ± 3.69, P = .06). Plasma CT-1 levels were not significantly different: 40.1 pg/mL (22.5-102.1) vs 37.2 pg/mL (23.5-67.2), P = .53.

CONCLUSION

Our results suggest worse ED in MINOCA than in INOCA patients, but demonstrated no difference in CT-1 levels between patients with stable and unstable ischemic heart disease and normal coronary arteries.

摘要

目的

无阻塞性冠状动脉疾病（MINOCA/INOCA）的心肌梗死/心肌缺血综合征越来越常见。许多此类患者存在导致缺血事件的内皮功能障碍（ED）。我们旨在比较 MINOCA 和 INOCA 患者的肱动脉血流介导的内皮依赖性血管舒张（血流介导的舒张[FMD]）和心营养素-1（CT-1）的血浆浓度。

方法

我们纳入了 42 例 MINOCA 患者和 38 例 INOCA 患者。通过测量肱动脉的 FMD%和硝酸甘油介导的扩张（NMD%）来评估内皮功能。通过固相酶联免疫吸附试验测定 CT-1 的血浆水平。

结果

MINOCA 患者的 FMD%明显低于 INOCA 患者（6.45±2.65%比 8.94±3.32%，P<0.001），而 NMD%无显著差异（10.69±3.19%比 12.16±3.69%，P=0.06）。血浆 CT-1 水平无显著差异：40.1pg/ml（22.5-102.1）比 37.2pg/ml（23.5-67.2），P=0.53。