期刊
CURRENT CARDIOLOGY REPORTS
卷 23, 期 3, 页码 -出版社
SPRINGER
DOI: 10.1007/s11886-021-01449-8
关键词
Coronary artery disease; Revascularization; Myocardial perfusion; Coronary flow reserve; Coronary flow capacity; Cardiac positron emission tomography
资金
- Weatherhead PET Center
Recent studies suggest that comprehensive, integrated quantification of myocardial perfusion may be the key to reducing mortality through revascularization in non-acute coronary artery disease. The lack of benefit from revascularization may be attributed to a narrow focus on individual aspects of coronary characteristics rather than considering all quantitative perfusion metrics per regional pixel.
Purpose of Review The COURAGE and ISCHEMIA trials showed no reduced mortality after revascularization compared to medical treatment. Is this lack of benefit due to revascularization having no benefit regardless of CAD severity or to suboptimal patient selection due to non-quantitative cardiac imaging? Recent Findings Comprehensive, integrated, myocardial perfusion quantified by regional pixel distribution of coronary flow capacity (CFC) is the final common expression of objective CAD severity for which revascularization reduces mortality. Current lack of revascularization benefit derives from narrow thinking focused on measuring one isolated aspect of coronary characteristics, such as angiogram stenosis, its fractional flow reserve (FFR), anatomic FFR simulations, relative stress imaging, absolute stress ml/min/g or coronary flow reserve (CFR) alone, or even more narrowly on global CFR or fixed regions of interest in assumed coronary artery distributions, or in arbitrary 17 segments on bull's-eye displays, rather than regional pixel distribution of perfusion metrics as they actually are in an individual. Comprehensive integration of all quantitative perfusion metrics per regional pixel into coronary flow capacity guides artery-specific interventions for reduced mortality in non-acute CAD but requires addressing the methodologic questions in the title.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据