UNASSIGNED:冠状动脉微血管功能障碍(CMD)在女性和男性的患病率和表现上存在差异;然而,我们对CMD性别差异的潜在因素了解有限。心肌灌注储备指数(MPRI),从心脏磁共振(CMR)成像得出的心肌灌注的半定量测量已被验证为CMD的测量。我们试图通过CMR了解MPRI与传统心血管疾病测量之间关系的性别差异。
UNASSIGNED:对2015年至2022年接受临床应激CMR的单中心队列患者进行了回顾性分析。包括具有计算的MPRI且没有与阻塞性心外膜冠状动脉疾病一致的可见灌注缺陷的患者。我们使用单变量和多变量回归模型比较了性别分层人群中MPRI与传统心血管危险因素和心脏结构/功能标志物之间的关联。
未经证实:共有229名患者[193名女性,36男,中位年龄57(47-67)岁]纳入分析.在女性人口中,没有传统的心血管危险因素与MPRI相关,而在男性人口中,在多变量模型中,糖尿病(β:-0.80,p=0.03)和高脂血症(β:-0.76,p=0.006)均与MPRI降低相关.多变量模型显示男性人群中MPRI降低与升主动脉直径增加(β:-0.42,p=0.005)和T1时间(β:-0.0056,p=0.03)之间存在显着关联。在女性人群中,T1(β:-0.0037,p=0.006)和LVMI(β:-0.022,p=0.0003)增加了。
UNASSIGNED:研究结果表明,男性与女性的CMD潜在病理生理学不同,男性患者MPRI较低,符合更“传统”的动脉粥样硬化特征。
UNASSIGNED: Coronary microvascular dysfunction (CMD) has differences in prevalence and presentation between women and men; however, we have limited understanding about underlying contributors to sex differences in CMD. Myocardial perfusion reserve index (MPRI), as semi-quantitative measure of myocardial perfusion derived from cardiac magnetic resonance (CMR) imaging has been validated as a measure of CMD. We sought to understand the sex differences in the relations between the MPRI and traditional measures of cardiovascular disease by CMR.
UNASSIGNED: A retrospective analysis of a single-center cohort of patients receiving clinical stress CMR from 2015 to 2022 was performed. Patients with calculated MPRI and no visible perfusion defects consistent with obstructive epicardial coronary disease were included. We compared associations between MPRI versus traditional cardiovascular risk factors and markers of cardiac structure/function in sex-stratified populations using univariable and multivariable regression models.
UNASSIGNED: A total of 229 patients [193 female, 36 male, median age 57 (47-67) years] were included in the analysis. In the female population, no traditional cardiovascular risk factors were associated with MPRI, whereas in the male population, diabetes (β: -0.80, p = 0.03) and hyperlipidemia (β: -0.76, p = 0.006) were both associated with reduced MPRI in multivariable models. Multivariable models revealed significant associations between reduced MPRI and increased ascending aortic diameter (β: -0.42, p = 0.005) and T1 times (β: -0.0056, p = 0.03) in the male population, and increased T1 times (β: -0.0037, p = 0.006) and LVMI (β: -0.022, p = 0.0003) in the female population.
UNASSIGNED: The findings suggest different underlying pathophysiology of CMD in men versus women, with lower MPRI in male patients fitting a more \"traditional\" atherosclerotic profile.