[Delayed clinical outcomes of coronary syndrome X: results of 15 year-long monitoring].
Clinical and pathomorphological outcomes of coronary syndrome X in 40 patients with intact subepicardial coronary arteries are analysed based on the results of 15 year-long monitoring. Primary examination revealed microvascular lesions in the coronary vessels in the form of idiopathic microangiopathy and plastic cardiomyocyte insufficiency confirmed by endomyocardial biopsy studies. The commonest undesirable outcomes after 15 years were myocardial infarction (7.5%), cerebral stroke (10%), persistent cardiac rhythm disturbance (15.4), and sudden cardiac death (17.5%). Sub-epicardial coronary arteries remained unaltered in 82.5% of the patients although they suffered atherosclerosis of peripheral arteries. It appears that coronary syndrome X is a specific microvascular form of coronary heart disease (MCHD) always coupled to systemic vascular pathology. The main consequence of MCHD is remodeled metabolism and biochemical changes contributing to multifocal systemic atherosclerosis. MCHD is diagnosed 10-15 years earlier than classical CHD. At the late stage of pathomorphogenesis, MCHD may remain a self-contained nosological form comparable with atherosclerotic CHD in terms of severity and clinical manifestations. MCHD is characterized by systemic atherosclerosis of peripheral arteries and (in 1/5 of the patients) by coronary atherosclerosis.
Telkova
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Vnushinskaia
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D000241:Adenosine / Q000008:administration & dosage; D000328:Adult; D001706:Biopsy; D003326:Coronary Circulation; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D003937:Diagnosis, Differential; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D017566:Microvascular Angina / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012189:Retrospective Studies; D012800:Siberia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D036542:Tomography, Spiral Computed; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D000241:Adenosine