Комплексний підхід до лікування ішемічної хвороби серця у пацієнтів з кардіоренальним метаболічним синдромом
Notice bibliographique
Résumé
Ischemic heart disease (IHD) remains the leading cause of mortality and disability due to cardiovascular diseases. IHD often manifests itself as stenosing atherosclerosis of the coronary arteries, which can be treated surgically or interventionally. However, chronic coronary syndromes with intact coronary vessels are a serious problem for modern medicine. Coronary microvascular dysfunction is accompanied by impaired coronary blood flow reserve, which leads to myocardial ischemia and angina pectoris, despite the absence of significant coronary artery stenosis. The objective: to study the mechanisms of myocardial ischemia in patients with coronary artery disease and cardiorenal metabolic (CRM) syndrome and to analyze the effectiveness of different treatment approaches depending on the identified mechanisms. Materials and methods. The study included 104 patients with CRM syndrome who underwent examination at the State Institution “The Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine” during 2023. Various forms of CHD were detected in the patients. Exercise stress tests were used to diagnose myocardial ischemia. Patients with confirmed stenosing atherosclerosis by percutaneous coronary angiography received appropriate interventional treatment. Microvascular angina was suspected in 21 patients without significant coronary artery lesions. The coronary blood flow reserve index was determined by echocardiography with intravenous administration of dipyridamole. Results. It was determined that of 21 patients with microvascular angina who received a comprehensive treatment including nicorandil, 20 (95.2%) persons were free of ischemic symptoms after 4 weeks. One patient had a decrease in complaints, but discomfort during exercise continued, which was successfully corrected after increasing the dose of nicorandil. Of 83 participants with CRM syndrome, CHD, and stenosing atherosclerosis who underwent coronary angiography, 74 (89.1%) patients had no ischemic symptoms and negative exercise test results after 28 days. In 9 cases ischemia persisted and a positive/doubtful exercise stress test was found. These patients were additionally prescribed nicorandil at a dose of 10 mg 2 times a day, which led to the disappearance of symptoms of angina pectoris and negative results of the exercise test at an additional re-examination after 7 days. Conclusions. In patients with CRM syndrome, the causes of ischemic heart disease were stenosing atherosclerosis (71.2%), microvascular angina (20.2%) and their combination (8.6%). Interventional treatment and nicorandil are effective in the treatment of coronary artery disease with different mechanisms, especially in cases of their combination.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,004 |
| Communication savante | 0,003 | 0,000 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,509 | 0,007 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».