孤立性右冠状动脉成形术对不稳定型心绞痛患者右心室功能的影响

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS International Cardiovascular Research Journal Pub Date : 2016-03-01 DOI:10.17795/ICRJ-10(1)49
Koza Yavuzer
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引用次数: 0

摘要

*通讯作者:Yavuzer Koza,土耳其阿塔图尔克大学医学院心脏病学系,埃尔祖鲁姆,Tel: +90-4422318503, E-mail: yavuzerkoza@hotmail.com在过去的三十年中,经皮冠状动脉介入治疗(PCI)已成为冠状动脉疾病治疗不可或缺的一部分。PCI降低st段抬高型心肌梗死(STEMI)的死亡率,改善非STEMI和不稳定型心绞痛的心血管结局(1,2)。然而,PCI在稳定型冠状动脉疾病治疗中的作用仍存在争议(3)。尽管由大量因素相互作用决定,但心肌梗死患者的预后与左心室(LV)功能和大小直接相关(4)。右心室一直是左心室后面的一个被遗忘的腔室。同样,大多数研究都评估了左室功能对预后的重要性,而对右心室的研究却很少。然而,急性STEMI患者行首次PCI治疗时,累及右心室与死亡率增加显著相关(5)。Nikdoust等人(6)在最近一期《国际心血管研究杂志》(International Cardiovascular Research Journal)上的研究强调,不稳定型心绞痛患者行右冠状动脉(RCA) PCI治疗后,右心室(RV)功能显著改善,但左室功能没有改善。在选择性PCI术前,共对30名受试者进行超声心动图测量。PCI术后2个月复查超声心动图并与基线比较。结果显示,左室收缩和舒张功能参数明显改善,但这些参数与左室功能无显著相关性。因此,作者认为RCA的血运重建可能对因缺血导致的右心室衰竭的患者有益。在相对较小的人群中,右冠状动脉PCI术后左室功能显著改善,而左室功能没有显著改善,这是有趣的。与本研究一致,先前的研究也报道了PCI术后RV功能的显著改善。然而,这些研究主要包括不同部位的STEMI患者(5)。在一项研究中,133例未合并左室梗死的下壁梗死患者接受了首次PCI治疗,只有局部左室►对卫生政策/实践/研究/医学教育的影响:迄今为止,经皮介入治疗对左室功能的影响已经被广泛研究,但对右心室的影响却很少。这篇文章强调了左右心室相互依赖的重要性,以及经皮冠状动脉介入治疗在孤立的右冠状动脉成形术后不同病变部位的右心室功能中的作用。
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The Impact of Isolated Right Coronary Artery Angioplasty on Right Ventricular Functions in Patients with Unstable Angina Pectoris
*Corresponding author: Yavuzer Koza, Ataturk University, Faculty of Medicine, Department of Cardiology, Erzurum, Turkey Tel: +90-4422318503, E-mail: yavuzerkoza@hotmail.com Percutaneous Coronary Intervention (PCI) has been an integral part of management of coronary artery disease over the past three decades. PCI reduces mortality in ST-segment Elevation Myocardial Infarction (STEMI) and improves cardiovascular outcomes in non-STEMI and unstable angina (1, 2). However, the role of PCI in management of stable coronary artery disease is still debatable (3). Although determined by interaction of a large number of factors, prognosis of patients with myocardial infarction is directly related to Left Ventricular (LV) function and size (4). In clinical practice, the right ventricle has remained a forgotten chamber behind the left ventricle. Likewise, most studies have evaluated the prognostic importance of LV function with little interest in the right ventricle. However, involvement of the right ventricle was significantly associated with increased mortality in patients with acute STEMI treated with primary PCI (5). The study by Nikdoust et al. (6) in a recent issue of the International Cardiovascular Research Journal highlights a significant improvement in Right Ventricular (RV) function, but not LV function, after Right Coronary Artery (RCA) PCI in patients with unstable angina. Echocardiographic measurements were performed in a total of 30 subjects prior to elective PCI. Two months after PCI, echocardiography was repeated and the results were compared to baseline. According to the findings, RV systolic and diastolic functional parameters were significantly improved, but there was no significant correlation between these parameters and LV function. Thus, the authors suggested that revascularization of the RCA might be beneficial for patients suffering from RV failure due to ischemia. The significant improvement in RV, but not LV, function, after right coronary PCI in a relatively small population is interesting. In agreement with this study, previous studies also reported significant improvements in RV function after PCI. However, these studies mainly included STEMI patients with different locations (5). In a study on 133 patients with inferior infarction without concomitant RV infarction who underwent primary PCI, only regional RV ►Implication for health policy/practice/research/medical education: To date, the impact of the percutaneous intervention on left ventricular function has been widely studied, with little interest in the right ventricle. This article highlights the importance of the interdependence of the right and left ventricles and the role of percutaneous coronary intervention in the right ventricular function with regard to different lesion sites after isolated right coronary angioplasty.
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来源期刊
International Cardiovascular Research Journal
International Cardiovascular Research Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
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