Left main coronary artery disease: A review of the spectrum of noninvasive diagnostic modalities
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- 作者：Nishtha Sareen MD…
- 关键词：Left main disease ; stress echocardiography ; single photon emission computed tomography ; positron emission tomography ; multivessel coronary disease
- 刊名：Journal of Nuclear Cardiology
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：23
- 期：6
- 页码：1411-1429
- 全文大小：2,220 KB
- 刊物主题：Cardiology; Nuclear Medicine; Imaging / Radiology;
- 出版者：Springer US
- ISSN：1532-6551
- 卷排序：23
文摘
Medically managed significant left main (LM) stem disease has been considered a determinant of increased cardiac mortality approaching 50% at 3-year follow-up. Despite the clinical significance of LM disease, studies comparing the various diagnostic modalities, especially noninvasive, are sparse. Clinicians, particularly imagers, should be aware of the strengths and weaknesses of existing modalities to diagnose LM disease as integrating many clues (history, symptoms, electrocardiogram, and stress hemodynamics are essential to suspect this diagnosis and proceed to the next step). Here we review the existing data on the current role of electrocardiography, nuclear myocardial perfusion imaging (single photon emission computed tomography and positron emission tomography), stress echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging in diagnostic evaluation of LM disease. Wherever applicable we have extended our discussion to multivessel coronary artery disease encompassing scenarios where LMS can present as LM equivalent with or without extensive multivessel coronary artery disease.