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Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention: A Consensus Document From the Academic Research Consortium for High Bleeding Risk ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons Management of No-Reflow Phenomenon in the Catheterization Laboratory A Novel Familial Cardiac Arrhythmia Syndrome with Widespread ST-Segment Depression Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement Percutaneous coronary intervention using a combination of robotics and telecommunications by an operator in a separate physical location from the patient: an early exploration into the feasibility of telestenting (the REMOTE-PCI study) Residual Inflammatory Risk in Patients With Low LDL Cholesterol Levels Undergoing Percutaneous Coronary Intervention Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association Digital learning and the future cardiologist Effect of Empagliflozin on Cardiovascular and Renal Outcomes in Patients With Heart Failure by Baseline Diabetes Status - Results from the EMPEROR-Reduced Trial

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心肌桥

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心肌桥(MB)是指不正常覆盖在冠状动脉上的心肌带。心肌桥患者通常无症状,但这种异常生理结构与劳累性心绞痛、急性冠状动脉综合征、心律失常、晕厥,甚至心脏猝死相关。有关MB的病理生理学、发生率及预测因子、诊疗策略、影像学测量及对不同患者群预后的影响可参考如下文献:


2014年“Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies汇总了当代MB的病理生理学及诊疗策略。


2018年10月“Fractional flow reserve derived from CCTA may have a prognostic role in myocardial bridging”评估了经CCTA测量的cFFR在预测心肌桥患者中的价值。


2019年1月“The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease”揭示了MB在胸痛和非阻塞性CAD患者中的发生率(208名观察患者中有14.2%人 ),并指出心肌桥与该患者群的心外膜和微血管内皮功能异常相关。


2019年2月“Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study”定量评价了覆盖在左前降支上的MB对左心室心肌灌注的影响。


2019年2月“Optical coherence tomography and intravascular ultrasound assessment of the anatomic size and wall thickness of a muscle bridge segment”通过OCT和IVUS明确心肌桥段的血管解剖结构。介绍与相邻的非MB段相比,MB段的冠状动脉既短又薄,解释这样的解剖结构可能造成支架置入术中严重冠状动脉穿孔频次的增加。


2019年3月Machine Learning Using CT-FFR Predicts Proximal Atherosclerotic Plaque Formation Associated With LAD Myocardial Bridging介绍了使用CT-FFR预测前降支心肌桥近端动脉粥样硬化斑块形成的可能。