Coronary Flow Reserve and Ischemic-like Electrocardiogram in Patients with Symptomatic Mitral Valve Prolapse.
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概要
- 論文の詳細を見る
The purpose of the present study was to determine whether coronary microvascular function is impaired in patients with symptomatic mitral valve prolapse (MVP) and whether ischemia-like ECG, if present, is related to coronary microvascular dysfunction. Twenty chest pain patients with normal coronary angiograms and MVP proven by echocardiogram were included. Both treadmill exercise test (TET) and coronary hemodynamic study were done in each patient. Coronary flow reserve (CFR) was determined by measuring coronary sinus flow (CSF) or great cardiac venous flow (GCVF) both at baseline and after dipyridamole 0.56 mg/kg IV for 4 minutes (maximum). All patients were divided into 2 groups with either negative (TET-) or positive results of TET (TET+). Another 10 subjects with atypical chest pain, normal coronary angiograms, echocardiogram and TET were used as controls. There were no differences in GCVF, either at baseline or after dipyridamole infusion, among the 3 groups. Calculated CFR using GCVF was similar among the 3 groups. However, baseline CSF was higher in the TET+ group (TET- vs TET+ vs control: 77 ± 24 vs 96 ± 31 vs 75 ± 12 ml/min, p < 0.05) and maximum CSF was lower in the TET- group (TET- vs TET+ vs control: 167 ± 25 vs 219 ± 85 vs 238 ± 80 ml/min, p < 0.05). Calculated CFR using CSF was significantly reduced in both the TET- (2.26 ± 0.4) and TET+ groups (2.31 ± 0.7) as compared with the control subjects (3.18 ± 0.95, p < 0.01). There were no differences in any of the hemodynamic parameters between the TET- and TET+ groups. Coronary microvascular function could be impaired in patients with symptomatic MVP. Such impairment, when presented, was probably regional and outside the territory of the left anterior descending coronary artery. However, it was irrelevant to the presence of ischemic-like ECG during exercise.
- International Heart Journal刊行会の論文
著者
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Chen Jaw-wen
Division Of Cardiology Department Of Internal Medicine Taipei Veterans General Hospital
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Lin Shing-jong
Division Of Cardiology Department Of Internal Medicine Taipei Veterans General Hospital
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Wu Tao-cheng
Division Of Cardiology Department Of Internal Medicine Taipei Veterans General Hospital
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CHANG Mau-Song
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Kaohsiung and Taipei
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CHEN Ying-Hwa
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan
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DING Yu-An
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan
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DING Yu-An
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
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CHEN Ying-Hwa
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
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HSU Nai-Wei
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan
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HSU Nai-Wei
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
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WANG Shih-Pu
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital and the National Yang Ming Medical College
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WU Tao-Cheng
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
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CHANG Mau-Song
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital and the National Yang Ming Medical College
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CHANG Mau-Song
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
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