Denise Peeters MSc , Eva Woelders MD , Tijn Jansen MD , Regina Konst MD, PhD , Caïa Crooijmans MD , Tim van de Hoef MD, PhD , Frans Mensink MD , Jonathan Los MD , Dario Pellegrini MD, PhD , Jan Hein Cornel MD, PhD , Peter Ong MD, PhD , Niels van Royen MD, PhD , Aukelien Leen MD, PhD , Suzette Elias-Smale MD, PhD , Robert Jan van Geuns MD, PhD , Peter Damman MD, PhD
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引用次数: 0
Abstract
In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.
在接受冠状动脉功能检测的心绞痛或心肌缺血且冠状动脉无阻塞的患者中，至少有二分之一的患者会被检测出冠状动脉痉挛（CAS）。CAS 与反复发作和缺血事件的不良预后有关。目前的治疗方案主要针对主诉，而非潜在的病理生理过程。在这篇综述中，我们讨论了有关 CAS 患者动脉粥样硬化的存在、数量和形态的现有证据。综述证据证实，在 CAS 患者中经常可以发现动脉粥样硬化和易损斑块特征。与弥漫性 CAS 患者相比，局灶性 CAS 患者的动脉粥样硬化程度更高。动脉粥样硬化的严重程度与 CAS 的存在有关，动脉粥样硬化性狭窄的 CAS 患者预后较差。因此，伴有动脉粥样硬化的 CAS 患者可能会从有针对性的动脉粥样硬化治疗中获益。要阐明动脉粥样硬化与 CAS 之间的确切关系，还需要进行纵向研究。
期刊介绍：
JACC: Cardiovascular Imaging, part of the prestigious Journal of the American College of Cardiology (JACC) family, offers readers a comprehensive perspective on all aspects of cardiovascular imaging. This specialist journal covers original clinical research on both non-invasive and invasive imaging techniques, including echocardiography, CT, CMR, nuclear, optical imaging, and cine-angiography.
JACC. Cardiovascular imaging highlights advances in basic science and molecular imaging that are expected to significantly impact clinical practice in the next decade. This influence encompasses improvements in diagnostic performance, enhanced understanding of the pathogenetic basis of diseases, and advancements in therapy.
In addition to cutting-edge research,the content of JACC: Cardiovascular Imaging emphasizes practical aspects for the practicing cardiologist, including advocacy and practice management.The journal also features state-of-the-art reviews, ensuring a well-rounded and insightful resource for professionals in the field of cardiovascular imaging.
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