摘要

Aims: To determine the effects of percutaneous coronary intervention (PCI) on cardiac perfusion, cardiac function, and quality of life in patients with chronic total occlusion (CTO) lesion in left anterior descending (LAD) coronary artery.Methods and Results: Patients (n=99) with CTO lesion in the LAD coronary artery who had successfully undergone PCI were divided into three groups based on the SPECT/CTCA fusion imaging: (a) no severe cardiac perfusion defects (n=9); (b) reversible cardiac perfusion defects (n=40); or (c) fixed cardiac perfusion defects (n=50). No statistical difference of perfusion abnormality was observed at 6 months and 1 year after PCI in group (a). In group (b), SPECT/CTCA fusion imaging demonstrated that cardiac perfusion abnormality was significantly decreased 6 month and 1 year after PCI. Left ventricular ejection fraction (LVEF) increased significantly at 6 months and 1 year follow up. Quality of life improved at 6 months and 1 year after PCI procedure. Moreover, patients in group (c) also benefited from PCI therapy: a decrease in cardiac perfusion abnormality, an increase in LVEF, and an improvement in quality of life. PCI of coronary arteries in addition to LAD did not significantly affect cardiac function and quality of life improvement in each group.Conclusions: PCI exerts functional and clinical benefits in patients with CTO lesion in LAD coronary artery, particularly in patients with reversible cardiac perfusion defects. SPECT/CTCA fusion imaging may serve as a useful tool to evaluate the outcomes of patients with CTO lesion in LAD coronary artery.

译文

目的: 确定经皮冠状动脉介入治疗 (PCI) 对慢性完全闭塞 (CTO) 患者心脏灌注、心脏功能和生活质量的影响左前降支 (LAD) 冠状动脉病变。方法和结果: 患者 (n = 99)根据 SPECT/CTCA 融合成像将成功接受 PCI 的 LAD 冠状动脉 CTO 病变分为三组: (a) 无严重心脏灌注缺损 (n = 9); (b) 可逆性心脏灌注缺损 (n = 40); 或 (c) 固定心脏灌注缺损 (n = 50)。(A) 组在 PCI 术后 6 个月和 1 年观察到灌注异常无统计学差异。在 b 组中,SPECT/CTCA 融合成像显示心脏灌注异常在 PCI 术后 6 个月和 1 年显著减少。随访 6 个月和 1 年时,左心室射血分数 (LVEF) 显著增加。PCI 术后 6 个月和 1 年的生活质量得到改善。此外,(c) 组的患者也受益于 PCI 治疗: 心脏灌注异常减少,LVEF 增加,生活质量改善。除 LAD 外,冠状动脉 PCI 对各组的心脏功能和生活质量改善没有显著影响。结论: PCI 在伴有冠状动脉 CTO 病变的 LAD 患者中发挥了功能性和临床益处,尤其是在具有可逆性心脏灌注缺陷的患者中。SPECT/CTCA 融合成像可作为评估 LAD 冠状动脉 CTO 病变患者预后的有用工具。

chronic total occlusion

心血管 CTO 疾病
概述  :  

冠状动脉慢性完全闭塞病变(CTO)是指冠状动脉血流中断持续时间超过3个月以上的病变。在接受冠脉造影检查的患者中,CTO病变的检出率约为15%至30%,而在确诊冠心病的患者中,CTO的检出率约为30%至50%。多年以来,由于介入治疗成功率较低,这类病变被称为冠脉介入治疗“最后的堡垒”。近年来,随着大量冠脉介入医生经验的积累及交流,以及CTO专用器械的不断涌现,CTO介入治疗的手术成功率明显提高,富有经验的术者成功率甚至超过90%,接近非闭塞病变的手术成功率,而且围手术期并发症发生率也控制在可以

Chronic 英 ['krɒnɪk] 美 ['krɑnɪk]

释义   adj. 慢性的;长期的;习惯性的

例句   As an oncologist, my goal would be to one day see that we can transform cancer into a chronic disease.

作为一名肿瘤学家,我的目标是有一天能看到我们将癌症转变成一种慢性疾病。

 

Occlusion 英 [ə'kluːʒ(ə)n] 美 [ə'kluʒən]

释义   n.闭塞;吸收

例句   Objective To observe the relationship between cerebral border zone infarction and cerebral artery stenosis or occlusion.

目的观察交界区脑梗死与颅内外主要动脉狭窄或闭塞的关系。


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