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急性和慢性冠心病中脉络膜结构与心肌侧支血流调节的关系。

Relationship between choroidal structure and myocardial collateral flow regulation in acute and chronic coronary heart disease.

作者信息

Arslan Gurcan Dogukan, Dogan Levent, Dogan Zeki, Kiziltoprak Hasan

机构信息

Department of Ophthalmology, Istanbul Medicine Hospital, Goztepe District, 2366th Street, Bagcilar, 34214, Istanbul, Turkey.

Department of Ophthalmology, Tatvan State Hospital, Bitlis, Turkey.

出版信息

Int Ophthalmol. 2025 Mar 30;45(1):132. doi: 10.1007/s10792-025-03515-4.

Abstract

PURPOSE

This study aimed to evaluate the relationship between coronary collateral filling, collateral size, and choroidal parameters in patients with acute and chronic coronary heart disease (CHD).

METHODS

Thirty-eight patients with acute CHD and 38 with chronic CHD who underwent diagnostic angiography in a cardiology clinic were included in this observational cross-sectional study. The control group comprised 32 healthy participants, and we examined both eyes of all participants. Diagnostic coronary angiograms were used to score the coronary collaterals, and choroidal parameters were measured in patients with CHD.

RESULTS

Choroidal vascular index (CVI) and subfoveal choroidal thickness (SFCT) were significantly lower in the chronic CHD group than in the acute CHD and control groups (p < 0.05). In the multinominal logistic regression analysis, collateral size had a significant association with both CVI (OR, 0.751; 95% CI, 0.596-0.947), and SFCT (OR, 0.986; 95% CI, 0.976-0.996) in patients with chronic CHD (p < 0.05). However, in the acute CHD group, no significant relationship was observed among choroidal parameters, collateral size, and filling.

CONCLUSION

Patients with chronic CHD had the lowest mean CVI and SFCT among the three groups, and this may be helpful in indicating chronic myocardial ischaemia. Moreover, an association was observed between larger collateral size and reduced CVI and SFCT in patients with chronic CHD, which may potentially be triggered by decreased angiogenic factors.

摘要

目的

本研究旨在评估急性和慢性冠心病(CHD)患者的冠状动脉侧支循环充盈、侧支大小与脉络膜参数之间的关系。

方法

本项观察性横断面研究纳入了38例在心脏病诊所接受诊断性血管造影的急性CHD患者和38例慢性CHD患者。对照组包括32名健康参与者,我们对所有参与者的双眼进行了检查。使用诊断性冠状动脉血管造影对冠状动脉侧支进行评分,并测量CHD患者的脉络膜参数。

结果

慢性CHD组的脉络膜血管指数(CVI)和黄斑中心凹下脉络膜厚度(SFCT)显著低于急性CHD组和对照组(p < 0.05)。在多项逻辑回归分析中,慢性CHD患者的侧支大小与CVI(比值比,0.751;95%可信区间,0.596 - 0.947)和SFCT(比值比,0.986;95%可信区间,0.976 - 0.996)均有显著关联(p < 0.05)。然而,在急性CHD组中,未观察到脉络膜参数、侧支大小和充盈之间存在显著关系。

结论

在三组中,慢性CHD患者的平均CVI和SFCT最低,这可能有助于提示慢性心肌缺血。此外,在慢性CHD患者中观察到较大的侧支大小与降低的CVI和SFCT之间存在关联,这可能是由血管生成因子减少所触发的。

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