РОЛЬ ПОЗИТРОННО-ЭМИССОННОЙ ТОМОГРАФИИ МИОКАРДА В ДИАГНОСТИКЕ ИШЕМИИ ПРИ НЕОБСТРУКТИВНОЙ БОЛЕЗНИ КОРОНАРНЫХ АРТЕРИЙ
Обзорная статья
Дата публикации: марта 12, 2020
Ключевые слова
миокард
компьютерная томография
дисфункция микроциркуляторного русла.
компьютерная томография
дисфункция микроциркуляторного русла.
Как цитировать
[1]
В. Б. Сергиенко и Ф. Н. Чанахчян, РОЛЬ ПОЗИТРОННО-ЭМИССОННОЙ ТОМОГРАФИИ МИОКАРДА В ДИАГНОСТИКЕ ИШЕМИИ ПРИ НЕОБСТРУКТИВНОЙ БОЛЕЗНИ КОРОНАРНЫХ АРТЕРИЙ, КМКВ, вып. 1, сс. 98-106, мар. 2020.
Аннотация
Полученные в ходе крупных клинических исследований данные продемонстрировали, что необструктивное поражение коронарных артерий из себя представляет отдельную нозологическую форму, при наличии которой риск развития неблагоприятных сердечно-сосудистых осложнений столь же существенен, как при обструктивном поражении коронарных артерий. При этом основной из причин развития данной патологии является нарушение кровотока на уровне коронарной микроциркуляции. В связи ограниченной способностью инвазивной коронарографии визуализировать и оценивать наличие дисфункции сосудов микроциркуляторного коронарного русла, в настоящее время большое внимание уделяется неинвазивным диагностическим визуализирующим пособиям, таким как однофотонная эмиссионная компьютерная томография и позитронно-эмиссионная томография миокарда, с помощью которых возможно решить данную задачу. В данной статье анализируется роль и преимущества указанных неинвазивных диагностических методов исследования в оценке гемодинамически незначимого коронарного атеросклероза, что может быть полезно клиницистам при выборе дальнейшей тактики ведения и лечения у пациентов данной популяции с целью минимизации риска развития осложнений со стороны сердечно-сосудистой системы.Литература
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2. Johnston N., Schenck-Gustafsson K., Lagerqvist B. Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain? Eur Heart J. 2011; 32 (11): 1331–1336. doi: 10.1093/eurheartj/ehr009.
3. Rahman H., Ryan M., Lumley M., Modi B., McConkey H., Ellis H. et al. Coronary Microvascular Dysfunction Is Associated With Myocardial Ischemia and Abnormal Coronary Perfusion During Exercise. Circulation. 2019; 140: 1805-1816. doi: 10.1161/CIRCULATIONAHA.119.041595.
4. Herscovici R., Sedlak T., Wei J., Pepine C.J., Handberg E., Bairey Merz C.N. Ischemia and No Obstructive Coronary Artery Diseases (INOCA): What is the Risk? JAHA. 2018; 7: e008868. doi: 10.1161/JAHA.118.008868.
5. Pepine C.J., Ferdinand K.C., Shaw L.J., Light-McGroary K.A., Shah R.U., Gulati M. et al. Committee ACiW: emergence of nonobstructive coronary artery disease: a Woman's problem and need for change in definition on angiography. J Am Coll Cardiol. 2015; 66 (17): 1918–1933. doi: 10.1016/j.jacc.2015.08.876.
6. Sharaf B., Wood T., Shaw L., Johnson B.D., Kelsey S., Anderson R.D. et al. Adverse outcomes among women presenting with signs and symptoms of ischemia and no obstructive coronary artery disease: findings from the National Heart, Lung, and Blood Institute-sponsored Women's ischemia syndrome evaluation (WISE) angiographic core laboratory. Am Heart J. 2013; 166 (1): 134–141. doi: 10.1016/j.ahj.2013.04.002.
7. Maddox T.M., Stanislawski M.A., Grunwald G.K., Bradley S.M., Ho P.M., Tsai T.T. et al. Nonobstructive coronary artery disease and risk of myocardial infarction. JAMA. 2014; 312 (17): 1754–1763. doi: 10.1001/jama.2014.14681.
8. Sara J.D., Widmer R.J., Matsuzawa Y. Lennon R.J., Lerman L.O., Lerman A. Prevalence of coronary microvascular dysfunction among patients with chest pain and nonobstructive coronary artery disease. JACC Cardiovasc Interv. 2015; 8: 1445-1453. doi: 10.1016/j.jcin.2015.06.017.
9. Pasupathy S., Air T., Dreyer R.P., Tavella R., Beltrame J.F. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Circulation. 2015; 131 (10): 861–870. doi: 10.1161/CIRCULATIONAHA.114.011201.
10. Agewall S., Beltrame J.F., Reynolds H.R., Niessner A., Rosano G., Caforio A.L. et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Eur Heart J. 2017; 38 (3): 143–153. doi: 10.1093/eurheartj/ehw149.
11. Gehrie E.R., Reynolds H.R., Chen A.Y., Neelon B.H., Roe M.T., Gibler W.B. et al. Characterization and outcomes of women and men with non-ST-segment elevation myocardial infarction and nonobstructive coronary artery disease: results from the can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines (CRUSADE) quality improvement initiative. Am Heart J. 2009; 158(4): 688–694. doi: 10.1016/j.ahj.2009.08.004.
12. Kissel C.K., Chen G., Southern D.A., Galbraith P.D., Anderson T.J., APPROACH investigators. Impact of clinical presentation and presence of coronary sclerosis on long-term outcome of patients with non-obstructive coronary artery disease. BMC Cardiovasc Disord. 2018; 18: 173. doi:10.1186/s12872-018-0908-z.
13. Camici P.G., d'Amati G., Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol. 2015; 12 (1): 48-62. doi: 10.1038/nrcardio.2014.160.
14. Bugiardini R., Bairey Merz C.N. Angina with "normal" coronary arteries: a changing philosophy. JAMA. 2005; 293 (4): 477-84. doi: 10.1001/jama.293.4.477.
15. Bairey Merz C.N., Pepine C.J., Walsh M.N., Fleg J.L. Ischemia and No Obstructive Coronary Artery Disease (INOCA): Developing Evidence-Based Therapies and Research Agenda for the Next Decade. Circulation. 2017; 135 (11): 1075-1092. doi: 10.1161/CIRCULATIONAHA.116.024534.
16. Opherk D., Mall G., Zebe H., Schwarz F., Weihe E., Manthey J. et al. Reduction of coronary reserve: a mechanism for angina pectoris in patients with arterial hypertension and normal coronary arteries. Circulation. 1984; 69: 1-7. doi: 10.1161/01.cir.69.1.1.
17. Reis S.E., Holubkov R., Conrad Smith A.J., Kelsey S.F., Sharaf B.L., Reichek N. et al. Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: results from the NHLBI WISE study. Аm Heart J. 2001; 141: 735-741. doi: 10.1067/mhj.2001.114198.
18. Doyle M., Fuisz A., Kortright E., Biederman R.W., Walsh E.G., Martin E.T. et al. The impact of myocardial flow reserve on the detection of coronary artery disease by perfusion imaging methods: an NHLBI WISE study. J Cardiovasc Magn Reson. 2003; 5: 475-485. doi: 10.1081/jcmr-120022263.
19. Даренский Д.И., Жарова Е.А., Матчин Ю.Г. Инвазивные методы определения функциональной значимости коронарных стенозов пограничной степени выраженности. Кардиологический вестник. 2016; 2: 80-90.
20. Fearon W., De Bruyne B. The Shifting Sands of Coronary Microvascular Dysfunction. Circulation. 2019; 140: 1817-1819. doi: 10.1161/CIRCULATIONAHA.119.043952.
21. Беленков Ю.Н., Сергиенко В.Б. Роль неинвазивных методов исследования в диагностике атеросклероза. Кардиология. 2007; 10: 37-44.
22. Карпов Ю.А., Сергиенко В.Б, Самойленко Л.Е., Самко А.Н., Левцкий И.В., Першуков И.В. и др. Роль дисфункции эндотелия в развитии ишемии миокарда у больных ишемической болезнью сердца с неизмененными и малоизмененными коронарными артериями. Кардиология. 1999; 1: 25-30.
23. Карпова И.Е., Самойленко Л.Е., Соболева Г.Н., Сергиенко В.Б. и др. Применение однофотонной эмиссионной компьютерной томографии с 99mТс-МИБИ в сочетании с фармакологической пробой с аденозинтрифосфатом натрия в диагностике ишемии миокарда у больных с микроваскулярной стенокардией. Кардиология. 2014; 7: 4-8.
24. Samoylenko L.E., Sergienko V.B., Karpov Y.A., Sayutina E.V., Soboleva G.N., Samko A. et al. 99mTc-MIBI myocardial perfusion imaging: Non-invasive detection of endothelial dysfunction. J Nucl Card. 1997; 4. 10.1016/S1071-3581 (97) 91129-6. abstr.
25. Knaapen P., de Haan S., Hoekstra O.S., Halbmeijer R., Appelman Y.E., Groothuis J.G. et al. Cardiac PET-CT: advanced hybrid imaging for the detection of coronary artery disease. Neth Heart J. 2010; 18 (2): 90–98. doi: 10.1007/bf03091744.
26. Mayala H.A., Bakari K.H., Mghanga F.P., ZhaoHui W. Clinical significance of PET-CT coronary flow reserve in diagnosis of non-obstructive coronary artery disease. BMC Res Notes 2018; 11: 566. doi: 10.1186/s13104-018-3667-0.
27. Murthy V., Naya M., Taqueti V., Foster C.R., Gaber M., Hainer J. et al. Effects of Sex on Microvascular Dysfunction and Cardiac Outcomes. Circulation. 2014; 129: 2518-2527. doi: 10.1161/CIRCULATIONAHA.113.008507.
28. Goel S., Miller A., Agarwal C., Zakin E., Acholonu M., Gidwani U. et al. Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque. Radiol Res Pract. 2015; 2015: 410967. doi: 10.1155/2015/410967.
29. Libby P. Mechanisms of Acute Coronary Syndromes and Their Implications for Therapy. N Engl J Med. 2013; 368: 2004-2013. doi: 10.1056/NEJMra1216063.
30. Kouijzer I.J., Vos F.J., Janssen M.J., van Dijk A.P., Oyen W.J., Bleeker-Rovers C.P. The value of 18F-FDG PET/CT in diagnosing infectious endocarditis. Eur J Nucl Med Mol Imaging. 2013; 40 (7): 1102-7. doi: 10.1007/s00259-013-2376-0.
31. Rogers I.S., Nasir K., Figueroa A.L., Cury R.C., Hoffmann U., Vermylen D.A. et al. Feasibility of FDG imaging of the coronary arteries: comparison between acute coronary syndrome and stable angina. JACC Cardiovasc Imaging. 2010; 3 (4): 388-97. doi: 10.1016/j.jcmg.2010.01.004.
32. Shah P.K., Falk E., Badimon J.J., Fernandez-Ortiz A., Mailhac A., Villareal-Levy G. et al. Human monocyte-derived macrophages induce collagen breakdown in fibrous caps of atherosclerotic plaques. Potential role of matrix-degrading metalloproteinases and implications for plaque rupture. Circulation. 1995; 92 (6): 1565-9.
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