2016


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2016/№6

Clinical manifestations of transient myocardial ischemia and methods for diagnostics of stable coronary heart disease

Mikhaylova I. E.
Federal State Budgetary Educational Institution of Higher Education "Saint-Petersburg State University", 7/9 University Embankment, St.-Petersburg, 199034

Keywords: stable coronary heart disease, angina, pretest probability, noninvasive examinations

DOI: 10.18087/rhj.2016.6.2267

Angina, the most common form of stable coronary heart disease (CHD), is diagnosed based on characteristic complaints, detecting transient myocardial ischemia during functional stress tests, and morphology data on epicardial coronary arteries. Determining the pretest probability of disease and knowing the resolution of instrumental study methods helps select an optimal diagnostic algorithm, which would take into account features of a specific patient.
  1. Bösner S, Becker A, Haasenritter J, Abu Hani M, Keller H, Sönnichsen AC et al. Chest pain in primary care: epidemiology and pre-work-up probabilities. Eur J Gen Pract. 2009;15 (3):141–6.
  2. Nilsson S, Scheike M, Engblom D, Karlsson LG, Mölstad S, Akerlind I et al. Chest pain and ischaemic heart disease in primary care. Br J Gen Pract. 2003 May;53 (490):378–82.
  3. Verdon F, Herzig L, Burnand B, Bischoff T, Pécoud A, Junod M et al. Chest pain in daily practice: occurrence, causes and management. Swiss Med Wkly. 2008 Jun 14;138 (23-24):340–7.
  4. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016 Jan 26;133 (4):e38–360.
  5. Hemingway H, McGallum A, Shipley M, Manderbacka Kl, Martikainen P, Keskimäki I. Incidense and prognosis implications of stable angina pectoris among women and men. JAMA. 2006 Mar 22;295 (12):1404–11.
  6. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013 Oct;34 (38):2949–3003.
  7. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016 Jan 14;37 (3):267–315.
  8. Diamond GA. A clinically relevant classification of chest discomfort. J Am Coll Cardiol. 1983 Feb;1 (2 Pt 1):574–5.
  9. Campeau L. Letter: Grading of angina pectoris. Circulation. 1976 Sep;54 (3):522–3.
  10. Patel MR , Dai D, Hernandez AF, Douglas PS, Messenger J, Garratt KN et al. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. Am Heart J. 2014 Jun;167 (6):846–52.e2.
  11. Patel MR , Peterson ED, Dai D, Brennan JM, Redberg RF, Anderson HV et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010 Mar 11;362 (10):886–95.
  12. Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010 Jun 22;55 (25):2816–21.
  13. Layland J, Oldroyd KG, Curzen N, Sood A, Balachandran K, Das R et al. Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial. Eur Heart J. 2015 Jan 7;36 (2):100–11.
  14. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979 Jun 14;300 (24):1350–8.
  15. Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE et al. Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993 Jan 15;118 (2):81–90.
  16. Fox CS, Evans JC, Larson MG, Kannel WB, Levy D. Temporal trends in coronary heart disease mortality and sudden cardiac death from 1950 to 1999: the Framingham Heart Study. Circulation. 2004 Aug 3;110 (5):522–7.
  17. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB et al. Heart disease and stroke statistics: 2012 update: a report from the American Heart Association. Circulation. 2012 Jan 3;125 (1):e2-e220.
  18. Cheng VY, Berman DS, Rozanski A, Dunning AM, Achenbach S, Al-Mallah M et al. Performance of the traditional age, sex, and angina typicality-based approach for estimating pretest probability of angiographically significant coronary artery disease in patients undergoing coronary computed tomographic angiography: results from the multinational coronary CT angiography evaluation for clinical outcomes: an international multicenter registry (CONFIRM). Circulation. 2011 Nov 29;124 (22):2423–32.
  19. Genders TS, Steyerberg EW, Alkadhi H, Leschka S, Desbiolles L, Nieman K et al. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension. Eur Heart J. 2011 Jun;32 (11):1316–30.
  20. Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation. 2003 Jan 7;107 (1):149–58.
  21. Froelicher VF, Lehmann KG, Thomas R , Goldman S, Morrison D, Edson R et al. The electrocardiographic exercise test in a population with reduced workup bias: diagnostic performance, computerized interpretation, and multivariable prediction. Veterans Affairs Cooperative Study in Health Services #016 (QUEXTA) Study Group. Quantitative Exercise Testing and Angiography. Ann Intern Med. 1998 Jun 15;128 (12 Pt 1):965–74.
  22. Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J. 2006 Jun;27 (11):1341–81.
  23. Chelliah R , Anantharam B, Burden L, Alhajiri A, Senior R . Independent and incremental value of stress echocardiography over clinical and stress electrocardiographic parameters for the prediction of hard cardiac events in new-onset suspected angina with no history of coronary artery disease. Eur J Echocardiogr. 2010 Dec;11 (10):875–82.
  24. Sicari R , Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D et al. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr. 2008 Jul;9 (4):415–37.
  25. Bouzas-Mosquera A, Peteiro J, Álvarez-García N, Broullón FJ, Mosquera VX, García-Bueno L et al. Prediction of mortality and major cardiac events by exercise echocardiography in patients with normal exercise electrocardiographic testing. J Am Coll Cardiol. 2009 May 26;53 (21):1981–90.
  26. Voigt JU, Exner B, Schmiedehausen K, Huchzermeyer C, Reulbach U, Nixdorff U et al. Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation. 2003 Apr 29;107 (16):2120–6.
  27. Senior R , Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P. Contrast echocardiography: evidence-based recommendations by European Association of Echocardiography. Eur J Echocardiogr. 2009 Mar;10 (2):194–212.
  28. Ritchie JL, Bateman TM, Bonow RO, Crawford MH, Gibbons RJ, Hall RJ et al. Guidelines for clinical use of cardiac radionuclide imaging. Report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Radionuclide Imaging), developed in collaboration with the American Society of Nuclear Cardiology. J Am Coll Cardiol. 1995 Feb;25 (2):521–47.
  29. Beller GA, Zaret BL. Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease. Circulation. 2000 Mar 28;101 (12):1465–78.
  30. Kajander S, Joutsiniemi E, Saraste M, Pietila M, Ukkonen H, Saraste A  et al. Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally significant coronary artery disease. Circulation. 2010 Aug 10;122 (6):603–13.
  31. Danad I, Szymonifka J, Twisk JW, Norgaard BL, Zarins CK, Knaapen P, Min JK. Diagnostic performance of cardiac imaging methods to diagnose ischaemia-causing coronary artery disease when directly compared with fractional flow reserve as a reference standard: a meta-analysis. Eur Heart J. 2016 May 2; pii:ehw095.
  32. Lockie T, Ishida M, Perera D, Chiribiri A, De Silva K, Kozerke S et al. High-resolution magnetic resonance myocardial perfusion imaging at 3.0-Tesla to detect hemodynamically significant coronary stenoses as determined by fractional flow reserve. J Am Coll Cardiol. 2011 Jan 4;57 (1):70–5.
  33. Agatston AS, Janowitz WR , Hildner FJ, Zusmer NR , Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990 Mar 15;15 (4):827–32.
  34. Achenbach S, Raggi P. Imaging of coronary atherosclerosis by computed tomography. Eur Heart J. 2010 Jun;31 (12):1442–8.
  35. Meijboom WB, van Mieghem CA, Mollet NR , Pugliese F, Weustink AC, van Pelt N et al. 64-Slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol. 2007 Oct 9;50 (15):1469–75.
  36. Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E et al. Diagnostic performance of 64-multidetector-row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol. 2008 Nov 18;52 (21):1724–32.
  37. Mark DB, Berman DS, Budoff MJ, Carr JJ, Gerber TC, Hecht HS et al. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010 Jun 8;121 (22):2509–43.
  38. Hadamitzky M, Freissmuth B, Meyer T, Hein F, Kastrati A, Martinoff S et al. Prognostic value of coronary computed tomographic angiography for prediction of cardiac events in patients with suspected coronary artery disease. JACC Cardiovasc Imaging. 2009 Apr;2 (4):404–11.
  39. Min JK, Berman DS, Dunning A, Achenbach St, Al-Mallah M, Budoff MJ et al. All-cause mortality benefit of coronary revascularization vs. medical therapy in patients without known coronary artery disease undergoing coronary computed tomographic angiography: results from CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry). Eur Heart J. 2012 Dec;33 (24):3088–97.
  40. Xu L, Sun Z, Fan Z. Noninvasive physiologic assessment of coronary stenoses using cardiac CT. Biomed Res Int. 2015;2015:435737.
  41. Douglas PS, Hoffmann U, Patel MR , Mark DB, Al-Khalidi HR, Cavanaugh B et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015 Apr 2;372 (14):1291–300.
  42. Douglas PS, Pontone G, Hlatky MA, Patel MR , Norgaard BL, Byrne RA et al. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFR (CT): outcome and resource impacts study. Eur Heart J. 2015 Dec 14;36 (47):3359–67.
Mikhaylova I.E. Clinical manifestations of transient myocardial ischemia and methods for diagnostics of stable coronary heart disease. Russian Heart Journal. 2016;15 (6):448–460

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