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心肌桥近端冠状动脉狭窄的临床特征及相关因素:一项回顾性研究。

Clinical characteristics and factors associated with coronary stenosis proximal to a myocardial bridge: a retrospective study.

机构信息

First Department of Cardiology, Bayannaoer City Hospital, No. 98 Wulan Buhe Road, Linhe District, Bayannaoer City, 015000, Inner Mongolia Autonomous Region, China.

Department of Cardiac Rehabilitation, Bayannaoer City Hospital, Bayannaoer City, Inner Mongolia Autonomous Region, China.

出版信息

BMC Cardiovasc Disord. 2020 Aug 14;20(1):371. doi: 10.1186/s12872-020-01655-2.

Abstract

BACKGROUND

The association of myocardial bridge (MB) with cardiovascular risk and the possible cardiovascular risk factors remain unclear. This study aimed to explore the clinical characteristics and related factors of coronary stenosis proximal to an MB.

METHODS

This was a retrospective study of patients with symptoms of coronary atherosclerotic heart disease admitted between 10/2011 and 12/2014 to the Emergency and Cardiology Department of Bayannur Hospital, who underwent selective coronary angiography (SCAG). The patients were assigned to the non-stenosis and stenosis groups according to whether coronary stenosis was proximal to the MB.

RESULTS

Among 244 patients with MB and cardiovascular symptoms, 91 (37.3%) had stenosis proximal to the MB. Compared with the non-stenosis group, there were more males (80.2% vs. 55.6%, P < 0.001) and smokers (including those who had quit smoking) (P < 0.001) in the stenosis group. There were no significant differences in blood lipid-related indexes (TG, TC, HDL-C, LDL-C, and VLDL-C) between the two groups. Multivariable analysis suggested that MB location in the middle distal or distal segment of the left anterior descending artery (LAD) increased the odds of coronary stenosis proximal to the MB (OR = 0.439, 95% CI: 1.57-7.532, P = 0.002), which was then considered an independent factor associated with coronary stenosis proximal to the MB.

CONCLUSIONS

In patients diagnosed with an MB by SCAG, only MB located in the middle distal or distal segment of the LAD is independently associated with coronary stenosis proximal to the MB.

摘要

背景

心肌桥(MB)与心血管风险的关联以及可能的心血管危险因素仍不清楚。本研究旨在探讨冠状动脉近段 MB 处狭窄的临床特征及相关因素。

方法

这是一项回顾性研究,纳入了 2011 年 10 月至 2014 年 12 月期间在巴彦淖尔医院急诊和心内科因冠状动脉粥样硬化性心脏病症状就诊并接受选择性冠状动脉造影(SCAG)的 MB 患者。根据 MB 近端是否存在冠状动脉狭窄,将患者分为非狭窄组和狭窄组。

结果

在 244 例有 MB 和心血管症状的患者中,91 例(37.3%)存在 MB 近端狭窄。与非狭窄组相比,狭窄组中男性(80.2% vs. 55.6%,P<0.001)和吸烟者(包括已戒烟者)(P<0.001)更多。两组血脂相关指标(TG、TC、HDL-C、LDL-C 和 VLDL-C)无显著差异。多变量分析提示 MB 位于左前降支(LAD)中段或远段增加了 MB 近端冠状动脉狭窄的可能性(OR=0.439,95%CI:1.57-7.532,P=0.002),这被认为是 MB 近端冠状动脉狭窄的独立相关因素。

结论

在通过 SCAG 诊断为 MB 的患者中,只有位于 LAD 中段或远段的 MB 与 MB 近端冠状动脉狭窄独立相关。

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