洲会何作祥核心脏病学现状与进展a课件

1、1洲会何作祥核心脏病学现状与进展a 2洲会何作祥核心脏病学现状与进展a 3洲会何作祥核心脏病学现状与进展aCirculation 2000;102:126 4洲会何作祥核心脏病学现状与进展a 5洲会何作祥核心脏病学现状与进展aGupta et al, 1992 6洲会何作祥核心脏病学现状与进展a 田月琴,等,中华心血管病杂志,2005 7洲会何作祥核心脏病学现状与进展a Aden Rest Aden Rest Aden Rest 8洲会何作祥核心脏病学现状与进展a Can Gated SPECT improve sensitivity for CAD detection? 洲会何作祥核心脏病学

2、现状与进展a 10洲会何作祥核心脏病学现状与进展a Wang F, et al. Eur J Nucl Med Mol Imaging, 2009 11洲会何作祥核心脏病学现状与进展a 12洲会何作祥核心脏病学现状与进展a Examples of Coronary Artery Scans 13洲会何作祥核心脏病学现状与进展a 14洲会何作祥核心脏病学现状与进展a 15洲会何作祥核心脏病学现状与进展a 16洲会何作祥核心脏病学现状与进展a CTA and SPECT/ CTA for Detection of Hemodynamically Significant Coronary Lesio

3、ns Rispler JACC 2007; 49: 1059-67 0 50 100 Percent Sens Spec PPV NPVSens Spec PPV NPV CTASPECT/ CTA 9696 9999 63 95 31 77 17洲会何作祥核心脏病学现状与进展a Namdar M, et al. JNM 2005 18洲会何作祥核心脏病学现状与进展a 19洲会何作祥核心脏病学现状与进展a Adapted from Gibbons RJ, et al. J Am Coll Cardiol. 1999;33:2092-2197. Risk of Cardiac Death: 20

4、洲会何作祥核心脏病学现状与进展a Risk Stratification: Noninvasive Testing Markers Amount of infarcted myocardium Amount of jeopardized myocardium Degree of jeopardy 21洲会何作祥核心脏病学现状与进展a Risk Stratification: Noninvasive Testing Markers Left ventricular systolic function 22洲会何作祥核心脏病学现状与进展a 23洲会何作祥核心脏病学现状与进展a 24洲会何作祥核心脏

5、病学现状与进展a 25洲会何作祥核心脏病学现状与进展a Follow-up Time (Months) 9080706050403020100 Cumulative Event-Free Survival 1.0 .9 .8 .7 .6 .5 Yang MF, NMC, 2006 26洲会何作祥核心脏病学现状与进展a 27洲会何作祥核心脏病学现状与进展a 2.9 0.3 0.8 2.3 0.5 2.7 2.9 4.2 0.0 1.0 2.0 3.0 4.0 5.0 Event Rate/Year, % Cardiac Death MI Hachamovitch R, et al. Circul

6、ation. 1998;97:535-543. Scan Result * * * Mildly Abnormal Moderately Abnormal Severely Abnormal Normal 2946884455898 * P.001 *P.01 n SSS13 28洲会何作祥核心脏病学现状与进展aHachamovitch R, et al. Circulation 1998 29洲会何作祥核心脏病学现状与进展a 2,287 Consented to Participate (74% of protocol-eligible patients) 1,149 Were assign

7、ed to PCI group 46 Did not undergo PCI 27 Had a lesion that could not be dilated 1,006 Received at least one stent 784 Did not provide consent - 450 Did not receive MD approval - 237 Declined to give permission - 97 Had an unknown reason 107 Were lost to follow-up 1,149 Were included in the primary

8、analysis 1,138 Were assigned to medical-therapy group 97 Were lost to follow-up 1,138 Were included in the primary analysis 30洲会何作祥核心脏病学现状与进展a Shaw, L. J. et al. Circulation 2008;117:1283-1291 Kaplan-Meier survival for patients by Kaplan-Meier survival for patients by residual ischemiaresidual ischemia after 6 to 18 months of PCI+OMT or OMTafter 6 to 18 months of PCI+OMT or OMT 31洲会何作祥核心脏病学现状与进展a Han PP, et al. Chin J Med 2