[1]马兴鸿 汪蕾 方纬.核素心肌显像在冠状动脉慢性完全闭塞临床诊疗中的应用价值[J].心血管病学进展,2022,(4):313-317.[doi:10.16806/j.cnki.issn.1004-3934.2022.04.007]
　MA Xinghong,WANG Lei,FANG Wei.Application Value of Radionuclide Myocardial Imaging In the Clinical Diagnosis And Treatment of Coronary Chronic Total Occlusion[J].Advances in Cardiovascular Diseases,2022,(4):313-317.[doi:10.16806/j.cnki.issn.1004-3934.2022.04.007]
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核素心肌显像在冠状动脉慢性完全闭塞临床诊疗中的应用价值()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年4期
页码:
313-317
栏目:
综述
出版日期:
2022-04-25

文章信息/Info

Title:
Application Value of Radionuclide Myocardial Imaging In the Clinical Diagnosis And Treatment of Coronary Chronic Total Occlusion
作者:
马兴鸿 汪蕾 方纬
蕾 (中国医学科学院阜外医院核医学科,北京 100037)
Author(s):
MA Xinghong; WANG Lei; FANG Wei
(Department of Nuclear Medicine,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)
关键词:
冠状动脉慢性完全闭塞; 心肌灌注显像; 心肌代谢显像; 心肌缺血; 心肌存活; 经皮冠状动脉介入治疗
Keywords:
Coronary chronic total occlusion; Myocardial perfusion imaging; Myocardial metabolism imaging; Myocardial ischaemia; Myocardial viability; Percutaneous coronary intervention
DOI:
10.16806/j.cnki.issn.1004-3934.2022.04.007
摘要:
冠状动脉慢性完全闭塞（CTO）较为常见且预后不良。虽然CTO患者经皮冠状动脉介入治疗（PCI）的成功率已较以往明显提高，但PCI的治疗决策仍是有争议的问题。研究表明：CTO血管支配区域是否存在心肌缺血和存活心肌可能与从PCI治疗中获益的CTO患者的筛选及其预后密切相关。现综述应用核素心肌灌注显像和心肌代谢显像分别评估CTO病变血管支配区域的心肌缺血和存活心肌的相关研究，初步探讨这两种核素显像技术在CTO病变治疗决策和预后评估方面的应用价值。
Abstract:
Coronary chronic total occlusion (CTO) is common and has a negative prognosis. Although the success rate of percutaneous coronary intervention (PCI) for CTO patients has been significantly improved,yet the therapeutic strategy of PCI is controversial. Research has shown that whether myocardial ischaemia and viable myocardium was present or not in the territory dominated by CTO vessel probably associated with patient selection of PCI and prognosis. This article reviewed related studies of application of radionuclide myocardial perfusion imaging and myocardial metabolism imaging to assess myocardial ischaemia and viable myocardium in the territory dominated by CTO vessel,and preliminarily explored the application value of these two radionuclide imaging techniques in CTO lesion therapeutic strategy and prognostic evaluation.

参考文献/References:


[1]Tajti P,Burke MN,Karmpaliotis D,et al. Update in the percutaneous management of coronary chronic total occlusions[J]. JACC Cardiovasc Interv,2018,11(7):615-625.

[2]Ladwiniec A,Allgar V,Thackray S,et al. Medical therapy,percutaneous coronary intervention and prognosis in patients with chronic total occlusions[J]. Heart,2015,101(23):1907-1914.

[3]Watanabe H,Morimoto T,Shiomi H,et al. Chronic total occlusion in non-infarct-related artery is associated with increased short-and long-term mortality in patients with ST-segment elevation acute myocardial infarction complicated by cardiogenic shock (from the CREDO-Kyoto AMI registry)[J]. Catheter Cardiovasc Interv,2018,92(3):455-463.

[4]Anantha-Narayanan M,Garcia S. Contemporary approach to chronic total occlusion interventions[J]. Curr Treat Options Cardiovasc Med,2019,21(1):1.

[5]Wilson WM,Walsh SJ,Yan AT,et al. Hybrid approach improves success of chronic total occlusion angioplasty[J]. Heart ,2016,102(18):1486-1493.

[6]Yang JH,Kim BS,Jang WJ,et al. Optimal medical therapy vs. percutaneous coronary intervention for patients with coronary chronic total occlusion—A propensity-matched analysis[J]. Circ J,2016,80(1):211-217.

[7]Rha SW,Choi BG,Baek MJ,et al. Five-year outcomes of successful percutaneous coronary intervention with drug-eluting stents versus medical therapy for chronic total occlusions[J]. Yonsei Med J,2018,59(5):602-610.

[8]Henriques JP,Hoebers LP,R?munddal T,et al. Percutaneous intervention for concurrent?chronic total occlusions in?patients with?STEMI:the EXPLORE trial[J]. J Am Coll Cardiol,2016,68(15):1622-1632.

[9]Werner GS,Martin-Yuste V,Hildick-Smith D,et al. A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions[J]. Eur Heart J,2018,39(26):2484-2493.

[10]Lee SW,Lee PH,Ahn JM,et al. Randomized trial evaluating percutaneous coronary intervention for the treatment of chronic total occlusion[J]. Circulation,2019,139(14):1674-1683.

[11]Neumann FJ,Sousa-Uva M,Ahlsson A,et al. 2018 ESC/EACTS Guidelines on myocardial revascularization[J]. Eur Heart J,2019,40(2):87-165.

[12]Underwood SR,Anagnostopoulos C,Cerqueira M,et al. Myocardial perfusion scintigraphy:the evidence[J]. Eur J Nucl Med Mol Imaging,2004,31(2):261-291.

[13]Bengel FM,Higuchi T,Javadi MS,et al. Cardiac positron emission tomography[J]. J Am Coll Cardiol,2009,54(1):1-15.

[14]Vo MN,Brilakis ES,Kass M,et al. Physiologic significance of coronary collaterals in chronic total occlusions[J]. Can J Physiol Pharmacol,2015,93(10):867-871.

[15]Vefali H,Manda Y,Shirani J. Myocardial viability in coronary artery chronic total occlusion[J]. Curr Cardiol Rep,2015,17(1):552.

[16]Werner GS,Surber R,Ferrari M,et al. The functional reserve of collaterals supplying long-term chronic total coronary occlusions in patients without prior myocardial infarction[J]. Eur Heart J,2006,27(20):2406-2412.

[17]Aboul-Enein F,Kar S,Hayes SW,et al. Influence of angiographic collateral circulation on myocardial perfusion in patients with chronic total occlusion of a single coronary artery and no prior myocardial infarction[J]. J Nucl Med,2004,45(6):950-955.

[18]He ZX,Mahmarian JJ,Verani MS. Myocardial perfusion in patients with total occlusion of a single coronary artery with and without collateral circulation[J]. J Nucl Cardiol,2001,8(4):452-457.

[19]Sun XX,Li S,Fang W,et al. Preserved myocardial viability in patients with chronic total occlusion of a single coronary artery[J]. J Nucl Cardiol,2021,28(6):2812-2822.

[20]Dong W,Li J,Mi H,et al. Relationship between collateral circulation and myocardial viability of 18F-FDG PET/CT subtended by chronic total occluded coronary arteries[J]. Ann Nucl Med,2018,32(3):197-205.

[21]Wang L,Lu MJ,Feng L,et al. Relationship of myocardial hibernation,scar,and angiographic collateral flow in ischemic cardiomyopathy with coronary chronic total occlusion[J]. J Nucl Cardiol,2019,26(5):1720-1730.

[22]翟光耀,王建龙,刘宇扬,等. 18F-FDG PET/CT心肌代谢显像评价冠状动脉慢性闭塞性病变存活心肌及与侧枝循环形成的相关性[J]. 心肺血管病杂志,2018,37(5):458-463.

[23]Werner GS,Surber R,Kuethe F,et al. Collaterals and the recovery of left ventricular function after recanalization of a chronic total coronary occlusion[J]. Am Heart J,2005,149(1):129-137.

[24]Allahwala UK,Kott K,Bland A,et al. Predictors and prognostic implications of well-matured coronary collateral circulation in patients with a chronic total occlusion (CTO)[J]. Int Heart J,2020,61(2):223-230.

[25]Hachamovitch R,Hayes SW,Friedman JD,et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography[J]. Circulation,2003,107(23):2900-2907.

[26]Hachamovitch R,Berman DS,Shaw LJ,et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction[J]. Circulation,1998,97(6):535-543.

[27]Shaw LJ,Berman DS,Maron DJ,et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy[J]. Circulation,2008,117(10):1283-1291.

[28]Safley DM,Koshy S,Grantham JA,et al. Changes in myocardial ischemic burden following percutaneous coronary intervention of chronic total occlusions[J]. Catheter Cardiovasc Interv,2011,78(3):337-343.

[29]Schumacher SP,Kockx M,Stuijfzand WJ,et al. Ischaemic burden and changes in absolute myocardial perfusion after chronic total occlusion percutaneous coronary intervention[J]. EuroIntervention,2020,16(6):e462-e471.

[30]Sun D,Wang J,Tian Y,et al. Multimodality imaging evaluation of functional and clinical benefits of percutaneous coronary intervention in patients with chronic total occlusion lesion[J]. Theranostics,2012,2(8):788-800.

[31]Stuijfzand WJ,Biesbroek PS,Raijmakers PG,et al. Effects of successful percutaneous coronary intervention of chronic total occlusions on myocardial perfusion and left ventricular function[J]. EuroIntervention,2017,13(3):345-354.

[32]Schumacher SP,Stuijfzand WJ,de Winter RW,et al. Ischemic burden reduction and long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention[J]. JACC Cardiovasc Interv,2021,14(13):1407-1418.

[33]Wright S,Lichtenstein M,Grigg L,et al. Myocardial perfusion imaging (MPI) is superior to the demonstration of distal collaterals in predicting cardiac events in chronic total occlusion (CTO)[J]. J Nucl Cardiol,2013,20(4):563-568.

[34]Galassi AR,Werner GS,Tomasello SD,et al. Prognostic value of exercise myocardial scintigraphy in patients with coronary chronic total occlusions[J]. J Interv Cardiol,2010,23(2):139-148.

[35]Ma X,Guo L,Zhang H,et al. Predictive value of SPECT myocardial perfusion imaging in patients with unrevascularized coronary chronic total occlusion[J]. Ann Nucl Med,2022,36(2):191-199.?.

[36]翟光耀,王建龙,刘宇扬,等. 18F-FDG PET/CT心肌代谢显像和侧支循环形成对于冠状动脉慢性闭塞性病变心功能预后价值的比较分析[J]. 中华医学杂志,2018,98(17):1342-1346.

[37]Beanlands RS,Nichol G,Huszti E,et al. F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease:a randomized,controlled trial (PARR-2)[J]. J Am Coll Cardiol,2007,50(20):2002-2012.

[38]Bonow RO,Maurer G,Lee KL,et al. Myocardial viability and survival in ischemic left ventricular dysfunction[J]. N Engl J Med,2011,364(17):1617-1625.

[39]Pavlovic SV,Sobic-Saranovic DP,Beleslin BD,et al. One-year follow-up of myocardial perfusion and function evaluated by gated SPECT MIBI in patients with earlier myocardial infarction and chronic total occlusion[J]. Nucl Med Commun,2009,30(1):68-75.

[40]Umeji K,Kawasaki T,Koga H,et al. Clinical impact of successful recanalization for chronic total occlusion:insights from stress myocardial perfusion imaging[J]. Heart Vessels,2020,35(7):894-900.

[41]Schumacher SP,Driessen RS,Stuijfzand WJ,et al. Recovery of myocardial perfusion after percutaneous coronary intervention of chronic total occlusions is comparable to hemodynamically significant non-occlusive lesions[J]. Catheter Cardiovasc Interv,2019,93(6):1059-1066.

[42]Azzalini L,Jolicoeur EM,Pighi M,et al. Epidemiology,management strategies,and outcomes of patients with chronic total coronary occlusion[J]. Am J Cardiol,2016,118(8):1128-1135.

[43]Knuuti J,Wijns W,Saraste A,et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes[J]. Eur Heart J,2020,41(3):407-477.

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更新日期/Last Update: 2022-05-13