Local myocardial changes in oxygen and nutrient metabolism in patients with microvascular angina
Yu Yunfu
Chen Xiaozhen
Yan Rui
Sun Tao
Yan Jifeng
Abstract：Objective To investigate the changes in the local myocardial oxygen and nutrient metabolism in patients with microvascular angina.Methods A total of 22 patients with primary microvascular angina pectoris admitted to Fuwai Central China Vascular Hospital from January 2020 to June 2022 were selected as the observation group,and 18 patients without clinical symptoms of angina pectoris who underwent radiofrequency ablation due to parsmal supraventricular tachycardia during the same period were selected as the control group.The changes of local oxygen,substance metabolism,internal environment and myocardial microvascular function before and after myocardial microcirculation were observed in the two groups.Results The pH value and blood glucose level of the ostium of the coronary artery in observation group were lower than those in control group,and the lactic acid,oxygen partial pressure and oxygen saturation were higher than those in control group(all P＜0.05).The levels of pH value,lactic acid,blood glucose and oxygen saturation in blood of coronary sinus were lower than those of control group,and the PCO2 was higher than that of control group(all P＜0.05).The glucose uptake rate,lactate production rate,frame number of corrected thrombolysis test(TCFC),coronary sinus filling time(CSFT),micro-circulation resistance index(IMR)and plasma endothelin-1 level in observation group were higher than those in control group,and the level of nitric oxide was lower than that in control group(all P＜0.05).Pearson correlation analysis showed that microvascular angina pectoris was positively correlated with coronary TCFC(r=0.327,P=0.040),CSFT(r=0.435,P=0.006),IMR(r=0.826,P＜0.001)and endothelin-1(r=0.517,P=0.001).There was a negative correlation with nitric oxide(r=-0.504,P＜0.001).In addition,IMR was positively correlated with endothelin-1(r=0.480,P=0.002)and negatively correlated with nitric oxide(r=-0.505,P=0.001).Conclusion The overall myocardial oxygen supply and metabolism are normal in patients with micro vascular angina pectoris.Regional myocardial hypoperfusion,local hypoxia,internal environment acidification,myocardial glucose anaerobic colysis enhancement,microvasomotor dysfunction.
Keywords：Microvascular anginaMyocardial microcirculationMetabolic metabolismInternal environment
Publication Date：2024-05-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 669-673 )