ACTUALITĂȚI ÎN MANAGEMENTUL PACIENȚILOR CU BOALĂ CORONARIANĂ CRONICĂ NON-OBSTRUCTIVĂ

Autori

  • Olga DICUSAR
  • Tatiana CARAGEA Institute of Cardiology
  • Mihaela MUNTEANU IMSP Institutul de Cardiologie
  • Victoria IVANOV IMSP Institutul de Cardiologie
  • Mihail POPOVICI IMSP Institutul de Cardiologie

DOI:

https://doi.org/10.52692/1857-0011.2024.1-78.16

Cuvinte cheie:

BCC non-obstructivă, angina microvasculară, angină vasospastică

Rezumat

O mare majoritate (până la 70%) dintre pacienții supuși angiografiei coronariene din cauza anginei și a semnelor de ischemie miocardică nu au artere coronare obstructive. Studiile efectuate în ultimele decenii au evidențiat că disfuncția coronariană microvasculară (DCM) și vasospasmul epicardic sunt mecanismele fiziopatologice de bază ale bolii coronariene cronice (BCC) non-obstructive, iar în funcție de mecanismul subiacent se diferențiază trei endotipuri clinice: angina microvasculară, vasospastică și mixtă. Este demonstrat că diagnosticul corect și tratamentul personalizat în funcție de endotipul BCC non-obstructive este asociat cu o calitate mai bună a vieții și un prognostic mai favorabil pe termen lung.Pacienții cu BCC non-obstructivă necesită un control la fel de bun al factorilor lor de risc cardiovascular ca și pacienții cu obstrucția arterelor coronare. Statinele și inhibitorii enzimei de conversie ai angiotensinei (IECA) au efecte benefice la majoritatea pacienților. Tratamentul anti-anginal de prima linie sunt betablocantele și/sau blocante ale canalelor de calciu, în funcție de mecanismul subiacent (disfuncție coronariană microvasculară sau vasospastică). Medicamentele de linia a doua sunt ivabradina, ranolazina și nicorandilul, iar inhibitorii de rho-kinaza și antagoniștii receptorilor de endotelină reprezintă potențiale medicamente pentru tratamentul pacienților cu BCC non-obstructivă în viitor.

Biografii autori

Olga DICUSAR

cercetător științific, doctorand; Laboratorul științific ,,Cardiologie intervențională”

Tatiana CARAGEA, Institute of Cardiology

cercetător științific, doctorand; Laboratorul științific ,,Cardiologie intervențională”

Mihaela MUNTEANU, IMSP Institutul de Cardiologie

cercetător științific, dr. șt. med.; Laboratorul științific ,,Cardiologie intervențională”

Victoria IVANOV, IMSP Institutul de Cardiologie

prof.cercet., dr.hab.șt.med.; Laboratorul științific ,,Cardiologie intervențională”

Mihail POPOVICI , IMSP Institutul de Cardiologie

academician AȘM, prof.univ., dr.hab.șt.med.; Laboratorul științific ,,Cardiologie intervențională”

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