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Vojnosanitetski pregled
2019, vol. 76, br. 2, str. 136-143
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP170122069M

Creative Commons License 4.0
Dijagnostička vrednost sveobuhvatne neinvazivne procene morfoloških i funkcionalnih karakteristika koronarne bolesti
aMilitary Medical Academy, Clinic for Cardiology, Belgrade + University of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade
bUniversity of Belgrade, Faculty of Medicine, Clinical Centre of Serbia, Institute for Cardiovascular Diseases, Belgrade
cUniversity of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Emergency Internal Medicine, Belgrade
dMilitary Medical Academy, Clinic for Cardiology, Belgrade

e-adresa: zoz3377@gmail.com

Sažetak

Uvod/Cilj. Nedavno usvojena tehnika, Transtorakalna Doppler Ehokardiografija (TDE) omogućava procenu funkcionalne značajnosti suženja koronarne arterije. Koronarografija putem 'multi-slice' kompjuterizovane tomografije (MSCT) nam pruža informacije o morfološkim karakteristikama koronarne arterijske bolesti. Cilj istraživanja je bio da se proceni najpouzdaniji neinvazivni dijagnostički pristup u cilju detekcije značajnih stenoza na prednjoj descedentnoj arteriji (LAD) i desnoj koronarnoj arteriji (RCA). Metode. Studijom je obuhvaćeno 84 bolesnika, sa prethodno detektovanim aterosklerotskim lezijama na LAD i/ili RCA putem MSCT. Procena koronarne rezerve protoka (CFR) putem TDE sa adenozinom sprovedena je na LAD (n = 75) i RCA (n = 61), sa ukupno 136 koronarnih arterija za analizu. Invazivna koronarografija (ICA) je urađena kod svih bolesnika 24 do 48 sati posle CFR. Rezultati. Cochrans Q testom je dokazana je statistički značajna razlika između tehnika pri detekciji značajnih koronarnih lezija na LAD i RCA (p < 0,01). Dalje analize su ukazale na značajnu razliku između MSCT i CFR (p < 0,05), MSCT i ICA (p < 0,01), dok između CFR i ICA nije uočena statistički značajna razlika (p > 0,05). Najveća diskrepanca u rezultatima uočena je između CFR, ICA i MSCT kada su analizirane interemdijarne teške stenoze. Dijagnostičku pouzdanost MSCT za LAD je bila 66,67%, za RCA 75 %, a CFR za LAD 90% i za RCA 81,67%, pri detekciji značajnih aterosklerotskih lezija. Kada su rezultati obe tehnike bili u saglasnosti dijagnostička pouzdanost je unapređena i za LAD (97,33%) i za RCA (90%). Zaključak. Sveobuhvatna neinvazivna procena, kako morfoloških, tako i funkcionalnih karakteristika koronarne bolesti je optimalan pristup za neinvazivnu i preciznu procenu značajnosti aterosklerotskih lezija na koronarnim arterijama.

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