Рекомендації з мультимодальної візуалізації життєздатності міокарда: консенсус робочої групи Асоціації серцево-судинних хірургів України
Ключові слова:
стрес-ехокардіографія, магнітно-резонансна томографія серця та магістральних судин, однофотонна емісійна комп’ютерна томографія, позитронно-емісійна томографія, мультиспіральна комп’ютерна томографія
Анотація
Загибель кардіоміоцитів унаслідок некрозу при ішемічній хворобі серця лишається головним чинником серцевої недостатності. У цих умовах ідентифікація ступеня важкості втрати міокардіальної маси шляхом кардіовізуалізації та, навпаки, визначення життєздатності міокарда є корисними з клінічної точки зору для прийняття рішення та вибору лікувальної стратегії у пацієнтів з ішемічною дисфункцією лівого шлуночка.
У клінічній практиці життєздатність міокарда визначається як стан міокарда при гострих або хронічних формах ішемічної хвороби серця та іншій патології міокарда із скоротливою дисфункцією, але при збереженій метаболічній та електричній функції міокарда, що забезпечує потенціал до покращення функції міокарда за рахунок реваскуляризації та інших видів лікування. Існує декілька патофізіологічних станів, які пояснюють феномен життєздатності, що можуть співіснувати. Візуалізація в кардіології та кардіохірургії дозволяє ідентифікувати життєздатний міокард шляхом використання декількох принципів з метою визначення потенціальної відповіді міокарда на лікування та визначення оптимальних шляхів лікування.
Метою цих рекомендацій є забезпечення повноцінного та критичного огляду сучасних показань і методів оцінювання життєздатності міокарда, а також описання сучасних стандартів проведення та інтерпретації результатів мультимодальної візуалізації життєздатності міокарда з урахуванням сценаріїв, коли ці методи можуть бути корисними в сучасній клінічній практиці.
Посилання
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2. Underwood SR, Bax JJ, vom Dahl J, Henein MY, Knuuti J, van Rossum AC, Schwarz ER, Vanoverschelde JL, van der Wall EE, Wijns W. Imaging techniques for the assessment of myocardial hibernation. Report of a Study Group of the European Society of Cardiology. Eur Heart J. 2004;25(10):815-36. https://doi.org/10.1016/j.ehj.2004.03.012
3. Shah BN, Khattar RS, Senior R. The hibernating myocardium: current concepts, diagnostic dilemmas, and clinical challenges in the post-STICH era. Eur Heart J. 2013;34(18):1323-36. https://doi.org/10.1093/eurheartj/eht018
4. Vanoverschelde JL, Wijns W, Borgers M, Heyndrickx G, Depré C, Flameng W, Melin JA. Chronic myocardial hibernation in humans. From bedside to bench. Circulation. 1997;95(7):1961-71. https://doi.org/10.1161/01.cir.95.7.1961
5. Wijns W, Vatner SF, Camici PG. Hibernating myocardium. N Engl J Med. 1998;339(3):173-81. https://doi.org/10.1056/NEJM199807163390307
6. Kloner RA. Stunned and hibernating myocardium: where are we nearly 4 decades later? J Am Heart Assoc. 2020;9(3):e015502. https://doi.org/10.1161/JAHA.119.015502
7. Heyndrickx GR, Millard RW, McRitchie RJ, Maroko PR, Vatner SF. Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs. J Clin Invest. 1975;56:978-85. https://doi.org/10.1172/JCI108178
8. Rahimtoola SH. The hibernating myocardium. Am Heart J. 1989;117(1):211-21. https://doi.org/10.1016/0002-8703(89)90685-6
9. Bax JJ, Schinkel AF, Boersma E, Elhendy A, Rizzello V, Maat A, Roelandt JR, van der Wall EE, Poldermans D. Extensive left ventricular remodeling does not allow viable myocardium to improve in left ventricular ejection fraction after revascularization and is associated with worse long-term prognosis. Circulation. 2004;110(11 Suppl 1):II18-22. https://doi.org/10.1161/01.CIR.0000138195.33452.b0
10. Lima JA, Becker LC, Melin JA, Lima S, Kallman CA, Weisfeldt ML, Weiss JL. Impaired thickening of nonischemic myocardium during acute regional ischemia in the dog. Circulation. 1985;71(5):1048-59. https://doi.org/10.1161/01.cir.71.5.1048
11. Nagueh SF. Mechanical dyssynchrony in congestive heart failure: diagnostic and therapeutic implications. J Am Coll Cardiol. 2008;51(1):18-22. https://doi.org/10.1016/j.jacc.2007.08.052
12. Gewirtz H, Dilsizian V. Myocardial viability: survival mechanisms and molecular imaging targets in acute and chronic ischemia. Circ Res. 2017;120(7):1197-212. https://doi.org/10.1161/CIRCRESAHA.116.307898
13. McDiarmid AK, Pellicori P, Cleland JG, Plein S. Taxonomy of segmental myocardial systolic dysfunction. Eur Heart J. 2017;38(13):942-54. https://doi.org/10.1093/eurheartj/ehw140
14. Amzulescu MS, De Craene M, Langet H, Pasquet A, Vancraeynest D, Pouleur AC, Vanoverschelde JL, Gerber BL. Myocardial strain imaging: review of general principles, validation, and sources of discrepancies. Eur Heart J Cardiovasc Imaging. 2019;20(6):605-19. https://doi.org/10.1093/ehjci/jez041
15. Migrino RQ, Ahn KW, Brahmbhatt T, Harmann L, Jurva J, Pajewski NM. Usefulness of two-dimensional strain echocardiography to predict segmental viability following acute myocardial infarction and optimization using bayesian logistic spatial modeling. Am J Cardiol. 2009;104(8):1023-9. https://doi.org/10.1016/j.amjcard.2009.05.049
16. Lyseggen E, Skulstad H, Helle-Valle T, Vartdal T, UrheimS, Rabben SI, Opdahl A, Ihlen H, Smiseth OA. Myocardial strain analysis in acute coronary occlusion: a tool to assess myocardial viability and reperfusion. Circulation2005;112 (25):3901-10. https://doi.org/10.1161/CIRCULATIONAHA.105.533372
17. Huttin O, Marie PY, Benichou M, Bozec E, Lemoine S, Mandry D, Juillière Y, Sadoul N, Micard E, Duarte K, Beaumont M, Rossignol P, Girerd N, Selton-Suty C. Temporal deformation pattern in acute and late phases of ST-elevation myocardial infarction: incremental value of longitudinal post-systolic strain to assess myocardial viability. Clin Res Cardiol. 2016;105(10):815-26. https://doi.org/10.1007/s00392-016-0989-6
18. Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL; European Association of Echocardiography. Stress echocardiography expert consensus statement-executive summary: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur Heart J. 2009;30(3):278-89. https://doi.org/10.1093/eurheartj/ehn492
19. Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P, Edvardsen T, Lancellotti P; EACVI Scientific Documents Committee for 2014–16 and 2016–18; EACVI Scientific Documents Committee for 2014–16 and 2016–18. Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017. Eur Heart J Cardiovasc Imaging. 2017;18(11):1205-1205af. https://doi.org/10.1093/ehjci/jex182
20. Geleijnse ML, Fioretti PM, Roelandt JR. Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography. J Am Coll Cardiol. 1997;30(3):595-606. https://doi.org/10.1016/s0735-1097(97)00206-4
21. Afridi I, Qureshi U, Kopelen HA, Winters WL, Zoghbi WA. Serial changes in response of hibernating myocardium to inotropic stimulation after revascularization: a dobutamine echocardiographic study. J Am Coll Cardiol.1997;30(5):1233-40. https://doi.org/10.1016/s0735-1097(97)00308-2
22. Senior R, Lahiri A. Enhanced detection of myocardial ischemia by stress dobutamine echocardiography utilizing the “biphasic” response of wall thickening during low and high dose dobutamine infusion. J Am Coll Cardiol. 1995;26(1):26-32. https://doi.org/10.1016/0735-1097(95)00139-q
23. Picano E. Stress echocardiography. From pathophysiological toy to diagnostic tool. Circulation. 1992;85(4):1604-12. https://doi.org/10.1161/01.cir.85.4.1604
24. Pingitore A, Picano E, Colosso MQ, Reisenhofer B, Gigli G, Lucarini AR, Petix N, Previtali M, Bigi R, Chiarandà G, Minardi G, de Alcantara M, Lowenstein J, Sclavo MG, Palmieri C, Galati A, Seveso G, Heyman J, Mathias W Jr, Casazza F, Sicari R, Raciti M, Landi P, Marzilli M. The atropine factor in pharmacologic stress echocardiography. Echo Persantine (EPIC) and Echo Dobutamine International Cooperative (EDIC) Study Groups. J Am Coll Cardiol. 1996;27(5):1164-70. https://doi.org/10.1016/0735-1097(95)00586-2
25. Picano E, Bedetti G, Varga A, Cseh E. The comparable diagnostic accuracies of dobutamine-stress and dipyridamole-stress echocardiographies: a meta- analysis. Coron Artery Dis. 2000;11(2):151-9. https://doi.org/10.1097/00019501-200003000-00010
26. Bansal M, Jeffriess L, Leano R, Mundy J, Marwick TH. Assessment of myocardial viability at dobutamine echocardiography by deformation analysis using tissue velocity and speckle-tracking. JACC Cardiovasc Imaging. 2010;3(2):121-31. https://doi.org/10.1016/j.jcmg.2009.09.025
27. Hanekom L, Jenkins C, Jeffries L, Case C, Mundy J, Hawley C, Marwick TH. Incremental value of strain rate analysis as an adjunct to wall-motion scoring for assessment of myocardial viability by dobutamine echocardiography: a follow-up study after revascularization. Circulation. 2005;112(25):3892-900. https://doi.org/10.1161/CIRCULATIONAHA.104.489310
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Опубліковано
2022-06-24
Як цитувати
Лазоришинець, В. В., Руденко, А. В., Федьків, С. В., Поташев, С. В., Сало, С. В., & Мазур, О. А. (2022). Рекомендації з мультимодальної візуалізації життєздатності міокарда: консенсус робочої групи Асоціації серцево-судинних хірургів України. Український журнал серцево-судинної хірургії, 30(2), 88-110. вилучено із http://cvs.org.ua/index.php/ujcvs/article/view/496
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