doktorska disertacija
Maja Pirnat (Avtor), Tomaž Šeruga (Mentor), Rainer Rienmüller (Komentor), Marko Noč (Komentor)

Povzetek

Namen: Stopnja uspešnosti perkutanih koronarnih arterijskih posegov (PCI) na lezijah s kronično popolno okluzijo (CTO) se je v zadnjih letih povečala, vendar je izboljšanje funkcije možno le, če je prisotna viabilnost miokarda. Eden najpomembnejših dejavnikov ohranjanja viabilnoti miokarda je odpiranje in razvoj kolateral. Naša hipoteza je bila, da višja stopnja kolateral pomeni izboljšano viabilnost miokarda. Metode: Pri 38 bolnikih smo primerjali stopnjo kolateral, ocenjeno s konvencionalnim koronarnim angiogramom (CCA) in razvrščeno po klasifikaciji Rentrop, s parametri viabilnosti (delež brazgotine, krčljivost in EDWT), ki smo jih pridobili s preiskavo ocene viabilnosti z magnetno resonanco. Rezultati: Ugotovili smo statistično pomembno povezavo med stopnjo kolateral, določeno z metodo Rentrop, in deležem brazgotine, izmerjenim s CMR (p = 0,001; T = - 0,144). Naša študija kaže tudi močno statistično pomembno povezavo med stopnjo kolateral in krčljivostjo, ki je bila izmerjena na ordinalni način (normalna, blaga hipokinezija, huda hipokinezija, diskinezija in akinezija) (p = 8,86 × 10-8; T = 0,215). Obe asociaciji sta pokazali povečano razmerje med viabilnim in neviabilnimi miokardom glede na stopnjo kolateral. Ugotovili smo, da ima stopnja kolateral nizko NPV za neviabilen miokard (29%) in visoko PPV za viabilen miokard (82%) s skupno natančnostjo 74%. Zaključek: naša študija kaže, da bi bilo koristno rutinsko oceniti kolaterale pri angiografiji pri bolnikih s CTO za oceno viabilnosti miokarda.

Ključne besede

viabilnost miokarda;stopnja kolateral;CMR;CCA;metoda Rentrop;parametri viabilnosti;Bolezni krvožilja;Disertacije;Srce;Koronarna bolezen srca;Miokardni infarkt;Diagnostika;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.08 - Doktorska disertacija
Organizacija: UM - Univerza v Mariboru
Založnik: M. Pirnat]
UDK: 616.12/.13-005-008-073(043.3)
COBISS: 55651075 Povezava se bo odprla v novem oknu
Št. ogledov: 601
Št. prenosov: 47
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: CAN THE DEGREE OF CORONARY COLLATERALISATION BE USED IN CLINICAL ROUTINE AS A VALID ANGIOGRAPHIC PARAMETER OF VIABILITY
Sekundarni povzetek: Purpose: The success rate of percutaneous coronary artery intervention (PCI) of chronic total occlusion (CTO) lesions have increased in the recent years. However, improvement of function is only possible when significant myocardial viability is present. One of the most important factors of maintaining myocardial viability is the opening and development of collaterals. Our hypothesis was that with a higher degree of collaterals more viable myocardium is present. Methods: In 38 patients we compared the degree of collaterals, evaluated with a conventional coronary angiogram (CCA) and graded by the Rentrop classification, to viability parameters (transmural extent of the scar, contractility and EDWT) obtained in a viability study with magnetic resonance (MRI). Results: We found a statistically significant association of the degree of collaterals determined with Rentrop method and transmural extent of the scar as measured by CMR (p=0.001; T= -0.144). Our study also shows strong statistically significant association between the degree of collaterals and contractility measured in ordinal manner (normal, mild hypokinesia, severe hypokinesia, dyskinesia and akinesia) (p=8.86×10-8; T=0.215). Additionally, both associations showed an increase in the ratio between viable vs. non-viable myocardium with the degree of collaterals. We found that that the degree of collateralization has a low NPV for non-viable myocardium (29%) and high PPV for viable myocardium (82%) with overall accuracy of 74%. Conclusion: Our study suggests that it may be beneficial to routinely grade the collaterals at angiography in patients with CTO as an assessment of myocardial viability.
Sekundarne ključne besede: Myocardial viability;collateral grade;Rentrop method;viability parameter;
Vrsta dela (COBISS): Doktorska disertacija
Komentar na gradivo: Univ. v Mariboru, Medicinska fak.
Strani: XIII, 56 str.
ID: 12009330