优化左心室收缩功能不全合并冠状动脉慢性完全闭塞患者介入治疗结局的研究进展  

Advances in optimizing the outcome of percutaneous coronary intervention in patients with left ventricular systolic dysfunction and coronary chronic total occlusion

作　　者：张宇超 吴铮[1] 王韶屏[1] 柳景华[1] ZHANG Yu-chao;WU Zheng;WANG Shao-ping;LIU Jing-hua(Center for Coronary Artery Disease,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Cardiopulmonary and Vascular Diseases Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院冠心病中心,北京市心肺血管疾病研究所,北京100029

出　　处：《中国介入心脏病学杂志》2024年第7期396-404,共9页Chinese Journal of Interventional Cardiology

基　　金：国家自然科学基金项目(81970291、82170344)。

摘　　要：冠状动脉慢性完全闭塞(CTO)病变是经皮冠状动脉介入治疗(PCI)领域极具挑战的病变之一。在接受CTO-PCI的患者中,左心室收缩功能不全(LVSD)较为常见,这类患者通常表现出更为复杂的冠状动脉病变以及较多合并症,面临更高的PCI相关并发症发生风险,其血运重建临床获益亦存在争议。如何优化CTO-PCI策略及术后管理并改善患者结局,是当前亟待解决的问题。本文就LVSD合并CTO病变患者的临床特征、介入治疗获益、介入治疗策略、术后管理和近远期预后等方面进行综述,以期为优化LVSD合并CTO病变患者介入治疗的结局提供参考。Coronary chronic total occlusion(CTO)presents one of the most formidable challenges in percutaneous coronary intervention(PCI).Left ventricular systolic dysfunction(LVSD)is frequently observed in patients undergoing CTO-PCI,who often present with more complex coronary artery lesions and a higher burden of comorbidities,leading to an elevated risk of PCI-related complications.The clinical benefits of revascularization for these patients remain controversial.How to optimize the CTO-PCI strategy and postoperative management to improve patient outcomes represents an urgent issue.This review comprehensively summarizes the clinical characteristics,interventional benefits,interventional strategies,postoperative management,as well as the short-and long-term outcomes for patients with LVSD and CTO,aiming to provide a reference for optimizing the outcome of PCI in this unique and challenging patient subgroup.

关 键 词：慢性完全闭塞 左心室收缩功能不全 经皮冠状动脉介入治疗 

分 类 号：R541[医药卫生—心血管疾病]