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孤立性冠状动脉瘤的危险因素和主要不良心血管事件:一项观察性研究。

Risk factors and major adverse cardiovascular events of isolated coronary artery ectasia: An observational study.

机构信息

Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China.

School of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China.

出版信息

Medicine (Baltimore). 2024 Jun 7;103(23):e38413. doi: 10.1097/MD.0000000000038413.

Abstract

To evaluate the cardiac index and major adverse cardiovascular events (MACE) events between isolated coronary artery ectasia (CAE) and control groups over 1 year period from diagnosis. A total of 18 patients who were diagnosed with isolated CAE in the Second Hospital of Hebei Medical University from December 2020 to December 2021 were included in CAE group. About 36 patients with non-obstructive coronary artery lesions were included in the control group. All patients in 2 groups completed dobutamine stress echocardiography (DSE) during hospitalization. The chamber size, wall thickness, left ventricular ejection fraction, and left ventricular diastolic function indicators (including E/A ratio, e', and E/e' ratio) were measured. MACE and all-cause death were measured during follow-up after discharge. Interventricular septum thickness (IVSd), left ventricular posterior wall (LVPW) thickness in diastole and E/e' in CAE group were significantly higher than control group (P < .05). No significant differences were found in prognosis including angina, myocardial ischemia (MI), patient readmission and cardiovascular death (P > .05). In CAE group, coronary angiography showed dilation of left anterior descending (LAD) in 1 case, left circumflex (LCX) in 3 cases and right coronary artery (RCA) in 14 cases. Multivariate logistic regression analysis showed that BMI and IVSd were independent risk factors for CAE. IVSd, LVPW thickness in diastole and E/e' in CAE group were significantly higher than control group. BMI and IVSd were independent risk factors for isolated CAE, and had a good predictive value for isolated CAE.

摘要

评估孤立性冠状动脉瘤(CAE)和对照组患者在诊断后 1 年内的心脏指数和主要不良心血管事件(MACE)事件。本研究纳入了 2020 年 12 月至 2021 年 12 月在河北医科大学第二医院诊断为孤立性 CAE 的 18 例患者为 CAE 组,纳入了 36 例非阻塞性冠状动脉病变患者为对照组。两组患者在住院期间均完成了多巴酚丁胺负荷超声心动图(DSE)检查,测量了腔室大小、壁厚度、左心室射血分数和左心室舒张功能指标(包括 E/A 比值、e'和 E/e'比值)。出院后随访期间测量了 MACE 和全因死亡事件。CAE 组的室间隔厚度(IVSd)、舒张期左心室后壁(LVPW)厚度和 E/e'均显著高于对照组(P<0.05),但在预后方面(包括心绞痛、心肌缺血(MI)、患者再入院和心血管死亡)无显著差异(P>0.05)。CAE 组冠状动脉造影显示左前降支(LAD)扩张 1 例,左回旋支(LCX)扩张 3 例,右冠状动脉(RCA)扩张 14 例。多因素逻辑回归分析显示 BMI 和 IVSd 是 CAE 的独立危险因素。CAE 组的 IVSd、舒张期 LVPW 厚度和 E/e'均显著高于对照组。BMI 和 IVSd 是孤立性 CAE 的独立危险因素,对孤立性 CAE 有较好的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2589/11155586/a66ee8a83e22/medi-103-e38413-g001.jpg

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