ANOCA 的综合管理，第 1 部分 — 定义、患者群体和诊断：JACC 最先进的审查,Journal of the American College of Cardiology

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ANOCA 的综合管理，第 1 部分 — 定义、患者群体和诊断：JACC 最先进的审查
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2023-09-11 , DOI: 10.1016/j.jacc.2023.06.043
Bruce A Samuels ₁ , Samit M Shah ₂ , R Jay Widmer ₃ , Yuhei Kobayashi ₄ , Steven E S Miner ₅ , Viviany R Taqueti ₆ , Allen Jeremias ₇ , Ahmed Albadri ₁ , John A Blair ₈ , Kathleen E Kearney ₉ , Janet Wei ₁ , Ki Park ₁₀ , Ailin Barseghian El-Farra ₁₁ , Noa Holoshitz ₁₂ , Katherine B Janaszek ₁₃ , Manoj Kesarwani ₁₄ , Amir Lerman ₁₅ , Megha Prasad ₁₆ , Odayme Quesada ₁₇ , Harmony R Reynolds ₁₈ , Michael P Savage ₁₉ , Nathaniel R Smilowitz ₂₀ , Nadia R Sutton ₂₁ , Joseph M Sweeny ₂₂ , Olga Toleva ₂₃ , Timothy D Henry ₂₄ , Jeffery W Moses ₂₅ , William F Fearon ₂₆ , Jennifer A Tremmel ₂₇ ,

Affiliation

Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA.
Baylor Scott and White Health, Temple, Texas, USA.
New York Presbyterian Brooklyn Methodist Hospital/Weill Cornell Medical College, New York, New York, USA.
Southlake Regional Medical Centre, Newmarket, Ontario, Canada; School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Cardiovascular Imaging Program, Departments of Radiology and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
St Francis Hospital and Heart Center, Roslyn, New York, USA.
Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA.
Department of Medicine, University of Washington, Seattle, Washington, USA.
Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Department of Medicine, Division of Cardiology, University of California, Irvine, California, USA.
Ascension Columbia St Mary's, Milwaukee, Wisconsin, USA.
Baylor Scott and White Health, Plano, Texas, USA.
Division of Cardiovascular Medicine, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, California, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA.
Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio, USA; The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.
Sarah Ross Soter Center for Women's Cardiovascular Research, Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, New York, USA.
Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA; Cardiology Section, Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, New York, USA.
Division of Cardiovascular Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Medicine, Emory University, Atlanta, Georgia, USA.
The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.
St Francis Hospital and Heart Center, Roslyn, New York, USA; Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA.
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA; Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.

非阻塞性冠状动脉心绞痛（ANOCA）越来越受到人们的重视，并且可能影响近一半因疑似缺血性心脏病而接受侵入性冠状动脉造影该工作诊断包括冠状动脉微血管功能障碍、微血管和心外膜痉挛、心肌桥以及其他隐匿性冠状动脉异常。ANOCA 患者通常面临沉重的症状负担，并且在接受诊断之前可能会反复向多个医疗提供者就诊。鉴于建立诊断的挑战，ANOCA 患者经常经历无效和累犯，可能导致焦虑和抑郁。科学知识和诊断测试的进步现在允许对 ANOCA 进行无创常规评估，并在心导管实验室中通过冠状动脉功能测试 (CFT) 进行评估。CFT 包括诊断性冠状动脉造影、冠状动脉血流储备和微循环阻力评估、内皮功能障碍和冠状血管痉挛的激发测试、以及用于识别心肌桥的血管内成像，并根据需要进行血流动力学评估。

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更新日期：2023-09-15

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