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在慢性全闭症患者的皮肤冠状动脉干预后心肌输液功能的PET评估:系统性审查和元分析

Ziyu An¹, Jinfan Tian¹, Xin Zhao¹

¹Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Scandinavian cardiovascular journal : SCJ

|February 6, 2024

概括

穿皮冠状动脉干预 (PCI) 在慢性全闭区 (CTO) 和偏远地区显著改善心肌血流和冠状动脉流量储备. 这表明PCI后输液恢复广泛,有利于CTO和高缺血负担的患者.

科学领域:

心血管医学心血管医学
干预心脏病学干预心脏病学
核心脏病学核心脏病学

背景情况:

对于慢性冠状动脉全封闭 (CTO) 的皮肤穿冠状动脉干预 (PCI) 的临床益处仍在争论中.
PCI通常用于缓解症状和减少心肌缺血症.
具有广泛心肌区域的大型CTO可能代表了从重血管化中受益最多的群体.

研究的目的:

评估和比较CTO地区和PCI前后偏远地区的心肌输液.
评估PCI对心肌动脉血流 (MBF) 和冠状动脉流量储备 (CFR) 的影响,使用正子发射断层扫描 (PET).

主要方法:

在Cochrane图书馆和PubMed进行了系统的文献搜索,搜索了2022年11月28日之前发表的研究.
进行了五项研究 (2017-2022,592名患者) 的元分析.
标准化平均差异 (SMD) 和95%置信区间 (CI) 为心肌 perfusion 参数计算.

主要成果:

在CTO地区,PCI显著增加了压力MBF (MD: 1.70,95%CI: 1.33-2.08,p<0.001).
在CTO区域的冠状动脉流量储备 (CFR) 在PCI后也有所改善 (MD: 1.37,95%CI: 1.13-1.61,p<0.001).
在偏远地区的压力MBF和CFR也在PCI后显著增加 (分别为p=0.004和p=0.001).

结论:

在CTO和偏远的心肌区域中,PCI导致压力MBF和CFR的显著改善.
这些发现表明,在CTO患者中,PCI后血液 perfusion 的恢复显著.
对于患有CTO动脉和显著缺血性负担的患者来说,CTO-PCI有益.

关键词:

冠状动脉堵塞冠状动脉堵塞心肌动脉的血液流动.心肌输血功能的功能是心肌输血功能.定子发射断层扫描 (PET).

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