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Myocardial Perfusion SPECT Imaging in Patients after Percutaneous Coronary Intervention

机译:经皮冠状动脉介入治疗后患者心肌灌注SPECT显像

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摘要

Coronary artery disease (CAD) is the most prevalent form of cardiovascular disease affecting about 13 million Americans, while more than one million percutaneous transluminal intervention (PCI) procedures are performed annually in the USA. The relative high occurrence of restenosis, despite stent implementation, seems to be the primary limitation of PCI. Over the last decades, single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), has proven an invaluable tool for the diagnosis of CAD and patients’ risk stratification, providing useful information regarding the decision about revascularization and is well suited to assess patients after intervention. Information gained from post-intervention MPI is crucial to differentiate patients with angina from those with exo-cardiac chest pain syndromes, to assess peri-intervention myocardial damage, to predict-detect restenosis after PCI, to detect CAD progression in non-revascularized vessels, to evaluate the effects of intervention if required for occupational reasons and to evaluate patients’ long-term prognosis. On the other hand, chest pain and exercise electrocardiography are largely unhelpful in identifying patients at risk after PCI.Although there are enough published data demonstrating the value of myocardial perfusion SPECT imaging in patients after PCI, there is still debate on whether or not these tests should be performed routinely.
机译:冠状动脉疾病(CAD)是影响1300万美国人的最普遍的心血管疾病,而在美国,每年进行的经皮腔内介入治疗(PCI)程序超过一百万。尽管采用了支架,但再狭窄的发生率较高,似乎是PCI的主要局限性。在过去的几十年中,单光子发射计算机断层扫描(SPECT)心肌灌注成像(MPI)已被证明是诊断CAD和患者风险分层的宝贵工具,可提供有关血运重建决定的有用信息,非常适合评估患者经过干预。干预后MPI所获得的信息对于区分心绞痛患者与心脏外胸痛综合征患者,评估围手术期心肌损伤,预测PCI后再狭窄,检测未再血管化血管的CAD进展至关重要,评估由于职业原因而需要干预的效果,并评估患者的长期预后。另一方面,胸痛和运动心电图检查对识别PCI后有风险的患者无济于事。尽管有足够的公开数据证明了PCI后SPECT成像对患者的价值,但仍存在关于这些检查是否可行的争论应该常规执行。

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