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학술저널
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Cho, Sang-Geon (Department of Nuclear Medicine, Chonnam National University Hospital) Park, Ki Seong (Department of Nuclear Medicine, Chonnam National University Hospital) Kang, Sae-Ryung (Department of Nuclear Medicine, Chonnam National University Hospital) Kim, Jahae (Department of Nuclear Medicine, Chonnam National University Hospital) Jun, Haeng Man (Department of Nuclear Medicine, Chonnam National University Hospital) Cho, Jae Yeong (Department of Cardiology, Chonnam National University Hospital) Jeong, Hae Chang (Department of Cardiology, Chonnam National University Hospital) Kim, Ju Han (Department of Cardiology, Chonnam National University Hospital) Jeong, Geum-Cheol (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital) Park, Hee Jeong (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital) Kwon, Seong Young (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital) Min, Jung-Joon (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital) Bom, Henry Hee-Seung (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital) Song, Ho-Chun (Department of Nuclear Medicine, Chonnam National University)
저널정보
대한핵의학회 Nuclear medicine and molecular imaging : NMMI Nuclear medicine and molecular imaging : NMMI 제50권 제1호
발행연도
2016.1
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54 - 62 (9page)

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Purpose To evaluate the perfusion decrease in donor myocardium by collateral circulation and its correlation with angina pectoris in patients with chronic total occlusion (CTO) using myocardial perfusion single-photon emission computed tomography (MPS). Materials and Methods Thirty-six patients with single-vessel CTO without any other stenosis were included. All patients underwent MPS and coronary angiography (CAG) within 2 months. Total 72 donor arteries were evaluated for the grades of collaterals to the CTO artery using the Rentrop grading system on CAG. Perfusion defects and perfusion scores in donor and CTO territories were analyzed on MPS. Myocardial perfusion of donor and CTO territories were evaluated according to the presence of angina pectoris and the grades of collateral circulation. Results When the CTO territory was ischemic, symptomatic patients showed higher summed difference scores in the CTO territory compared to asymptomatic patients ($3.5{\pm}2.4$ vs. $1.5{\pm}0.8$ for symptomatic and asymptomatic groups respectively; p = 0.034). However, when the CTO territory was nonischemic, symptomatic patients showed higher summed stress scores (SSS, $4.3{\pm}2.9$ vs. $1.6{\pm}1.2$; p=0.032) and summed rest scores (SRS, $4.2{\pm}2.5$ vs. $1.5{\pm}1$.1; p=0.003) in the donor territories. On the per-vessel analysis, perfusion defects in donor territories were more frequent (0 % vs. 53 % vs. 86 % for Rentrop 0, Rentrop 1-2 and Rentrop 3, respectively; p<0.001) and showed higher SSS ($0.0{\pm}0.0$, $1.3{\pm}1.6$ and $2.1{\pm}1.1$ for Rentrop 0, Rentrop 1-2 and Rentrop 3, respectively; p=0.001) and SRS ($0.0{\pm}0.0$, $1.0{\pm}1.4$ and $1.7{\pm}1.2$; p=0.003) at higher Rentrop grades, but their patterns were variable. Conclusion Angina pectoris was related to either ischemia of the myocardium beyond CTO or a perfusion decrease in the donor myocardium. The perfusion decrease in donor myocardium positively correlated with the collateral grades.
#Coronary occlusion #Collateral circulation #Angina pectoris #Myocardial perfusion imaging

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참고문헌 (29)

참고문헌 신청
Shah PB / 2011 / Management of coronary chronic total occlusion / Circulation 123:1780~1784 google schola Kahn JK / 1993 / Angiographic suitability for catheter revascularization of total coronary occlusions in patients from a community hospital setting / Am Heart J 126:561~564 google schola Christofferson RD / 2005 / Effect of chronic total coronary occlusion on treatment strategy / Am J Cardiol 95:1088~1091 google schola Bardaji A / 2014 / Chronic total occlusion : to treat or not to treat / World J Cardiol 6:621~629 google schola Simons M / 2005 / Angiogenesis—Where do we stand now? / Circulation 111:1556~1566 google schola

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