avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2020-10-5-340-347avk-1087Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESПрименение перфузионной томосцинтиграфии миокарда при безболевой ишемии миокарда (обзор литературы)Application of Perfusion Single Photon Emission Computed Tomography of the Myocardium in Pain-Free Myocardial Ischemiahttps://orcid.org/0000-0003-0769-3682АбдрахмановаА. И.AbdrahmanovaA. I.

Алсу Ильдусовна Абдрахманова - кафедра Фундаментальных основ клинической медиотделение кардиологии, отделение кардиологии

Казань

Department of Fundamental Foundations of Clinical Medicine

Department of Cardiology

Kazan

alsuchaa@mail.ruАмировН. Б.AmirovN. B.

Кафедра поликлинической терапии и общей врачебной практики

МСЧ МВД России по РТ

Казань

Departmentof Polyclinic Therapy and General Medical Practice

 

ЦибулькинН. А.CibulkinN. A.

Кафедра кардиологии, рентгенэндоваскулярной и сердечно-сосудистой хирургии

Казань

Department of Cardiology, X-ray Endovascular and Cardiovascular Surgery

Kazan

ФГАОУ ВО «Казанский (Приволжский) федеральный университет»; ГАУЗ «Межрегиональный клинико-диагностический центр»РоссияKazan (Volga Region) Federal University; Interregional Clinical Diagnostic CenterRussian FederationФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РоссииРоссияKazan State Medical University, Ministry of Health of Russia; Medical sanitary unit of the Ministry of Internal Affairs of Russia in the Republicof TatarstanRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian Federation202007102020105340347Copyright © Абдрахманова А.И., Амиров Н.Б., Цибулькин Н.А., 20202020Абдрахманова А.И., Амиров Н.Б., Цибулькин Н.А.Abdrahmanova A.I., Amirov N.B., Cibulkin N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1087

В представленном обзоре медицинской литературы приведены данные об использовании метода однофотонной эмиссионной компьютерной томографии миокарда у пациентов с безболевой ишемией миокарда. Проблема в том, безболевая ишемия миокарда может быть первым проявлением ишемической болезни сердца, и повышать риск сердечно - сосудистых осложнений в несколько раз. Оценка состояния морфофункциональных процессов в миокарде является основной целью диагностической визуализации с помощью однофотонной эмиссионной компьютерной томографии миокарда. Э тот метод позволяет получить трехмерное изображение левого желудочка с информацией о распределении объема перфузии по миокарду, дает возможность более диагностировать безболевую ишемию миокарда. Проведение однофотонной эмиссионной компьютерной томографии в режиме ЭКГ-синхронизации позволяет визуализировать кинетику стенок миокарда в различные фазы сердечного цикла и тем самым одновременно оценивать функциональное состояние миокарда левого желудочка. Показатели сократительной функции миокарда левого желудочка в участках преходящей гипоперфузии могут быть предикторами кардиальных событий после перенесенного инфаркта миокарда и независимым предикторами периоперационных кардиальных событий у пациентов, подвергающихся кардиохирургическому вмешательству. Сочетание однофотонной эмиссионной компьютерной томографии миокарда с физической нагрузкой или фармакологическими тестами помогает выявить коронарный стеноз среди обследованных с безболевой ишемией миокарда, выявить показания для проведения инвазивных исследований. Перфузионная однофотонной эмиссионной компьютер-ной томографии миокарда — необходимый инструмент для стратификации риска и оценки прогноза заболеваний миокарда у асимптомных пациентов с безболевой ишемией миокарда.

This literature review provides data on the use of single-photon emission computed tomography of myocardium in silent myocardial ischemia. The presence of silent myocardial ischemia increases the risk of cardiovascular complications several times and may be the first manifestation of coronary heart disease. Assessing the state of morphofunctional processes in the myocardium is the main goal of diagnostic imaging using singlephoton emission computed tomography of the myocardium. This allows to get three-dimensional image of left ventricle with information about distribution of perfusion volume across myocardium, makes it possible to more accurately differentiate such condition as silent myocardial ischemia. Conducting single-photon emission computed tomography in ECG synchronization mode allows you to visualize the kinetics of the myocardial walls in different phases of the cardiac cycle and thereby simultaneously assess the functional state of the left ventricular myocardium. Indicators of contractile function of the left ventricular myocardium in areas of transient hypoperfusion can be predictors of cardiac events after myocardial infarction and independent predictors of perioperative cardiac events in patients undergoing cardiac surgery. Performing single-photon emission computed tomography in ECG-synchronization mode allows visualizing kinetics of myocardial walls in different phases of cardiac cycle and thereby simultaneously assessing functional state of left ventricle myocardium. In combination with physical exercise and pharmacological tests, it helps to identify coronary stenosis among patients with silent myocardial ischemia. Perfusion single-photon emission computed tomography of myocardium is a necessary tool for stratification and assessment of prognosis of cardiac diseases in asymptomatic patients.

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The authors declare that there are no conflicts of interest present.