Der Klinikarzt 2019; 48(04): 134-140
DOI: 10.1055/a-0888-2699
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Akutes Koronarsyndrom

Indikationen und Stellenwert nicht-invasiver Bildgebung
Steffen D. Kriechbaum
1   Abteilung für Kardiologie, Kerckhoff Herz- und Thoraxzentrum, Bad Nauheim
,
Andreas Rolf
1   Abteilung für Kardiologie, Kerckhoff Herz- und Thoraxzentrum, Bad Nauheim
2   Medizinische Klinik I, Abteilung Kardiologie/Angiologie, Universitätsklinikum Gießen, Gießen
› Author Affiliations
Further Information

Publication History

Publication Date:
03 May 2019 (online)

ZUSAMMENFASSUNG

Bei Verdacht auf ein ACS kommt nicht-invasive Bildgebung bei der Initialdiagnostik und der (sub-)akuten Risikostratifizierung zum Einsatz. Während die Ruhe-TTE (transthorakale Echokardiografie) zügig die kardiale Funktion und Differenzialdiagnosen des ACS evaluiert, ermöglichen Stress-TTE, Kardio-CT, Kardio-MRT und Szintigrafie die Detektion struktureller Koronarpathologien bzw. deren funktionelle Auswirkungen. Zudem liefert die Kardio-CT differenzialdiagnostische Informationen.

 
  • Literatur

  • 1 Roffi M, Patrono C, Collet JP. 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; 37: 267-315
  • 2 Montalescot G, Sechtem U, Achenbach S. et al. 2013 ESC guidelines on the management of stable coronary artery diseaseThe Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013; 34: 2949-3003
  • 3 Ibanez B, James S, Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39: 119-177
  • 4 Lancellotti P, Price S, Edvardsen T. et al. The use of echocardiography in acute cardiovascular care: recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care 2015; 4: 3-5
  • 5 Sechtem U, Achenbach S, Friedrich M. et al. Non-invasive imaging in acute chest pain syndromes. Eur Heart J Cardiovasc Imaging 2012; 13: 69-78
  • 6 Tong KL, Kaul S, Wang XQ. et al. Myocardial contrast echocardiography versus Thrombolysis In Myocardial Infarction score in patients presenting to the emergency department with chest pain and a nondiagnostic electrocardiogram. J Am Coll Cardiol 2005; 46: 920-927
  • 7 Sarvari SI, Haugaa KH, Zahid W. et al. Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non-ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging 2013; 6: 535-544
  • 8 Shah BN, Balaji G, Alhajiri A. et al. Incremental diagnostic and prognostic value of contemporary stress echocardiography in a chest pain unit: mortality and morbidity outcomes from a real-world setting. Circ Cardiovasc Imaging 2013; 6: 202-209
  • 9 Sicari R, Nihoyannopoulos P, Evangelista A. et al. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr 2008; 9: 415-437
  • 10 Lombardi M, Plein S, Petersen S. et al. The EACVI Textbook of Cardiovascular Magnetic Resonance. 1 ed. New York: Oxford University Press; 2018
  • 11 Grothues F, Smith GC, Moon JC. et al. Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol 2002; 90: 29-34
  • 12 Kim PK, Hong YJ, Im DJ. et al. Myocardial T1 and T2 Mapping: Techniques and Clinical Applications. Korean J Radiol 2017; 18: 113-131
  • 13 Francois CJ. Current state of the art cardiovascular MR imaging techniques for assessment of ischemic heart disease. Radiologic clinics of North America 2015; 53: 335-344
  • 14 Kim RJ, Fieno DS, Parrish TB. et al. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation 1999; 100: 1992-2002
  • 15 Kim RJ, Wu E, Rafael A. et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 2000; 343: 1445-1453
  • 16 Li M, Zhou T, Yang LF. et al. Diagnostic accuracy of myocardial magnetic resonance perfusion to diagnose ischemic stenosis with fractional flow reserve as reference: systematic review and meta-analysis. JACC Cardiovasc Imaging 2014; 7: 1098-1105
  • 17 Ingkanisorn WP, Kwong RY, Bohme NS. et al. Prognosis of negative adenosine stress magnetic resonance in patients presenting to an emergency department with chest pain. J Am Coll Cardiol 2006; 47: 1427-1432
  • 18 Jaarsma C, Leiner T, Bekkers SC. et al. Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis. J Am Coll Cardiol 2012; 59: 1719-1728
  • 19 Lim SH, Anantharaman V, Sundram F. et al. Stress myocardial perfusion imaging for the evaluation and triage of chest pain in the emergency department: a randomized controlled trial. J Nucl Cardiol 2013; 20: 1002-1012
  • 20 Brown KA. Prognostic value of thallium-201 myocardial perfusion imaging. A diagnostic tool comes of age. Circulation 1991; 83: 363-381
  • 21 Samad Z, Hakeem A, Mahmood SS. et al. A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department. J Nucl Cardiol 2012; 19: 364-376
  • 22 Hulten E, Pickett C, Bittencourt MS. et al. Outcomes after coronary computed tomography angiography in the emergency department: a systematic review and meta-analysis of randomized, controlled trials. J Am Coll Cardiol 2013; 61: 880-892
  • 23 Newby DE, Adamson PD, Berry C. et al. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. N Engl J Med 2018; 379: 924-933
  • 24 Tesche C, De Cecco CN, Albrecht MH. et al. Coronary CT Angiography-derived Fractional Flow Reserve. Radiology 2017; 285: 17-33
  • 25 Daniel O, Bittner M, Thomas Mayrhofer P. et al. Coronary Computed Tomography Angiography–Specific Definitions of High-Risk Plaque Features Improve Detection of Acute Coronary Syndrome. Circ Cardiovasc Imaging 2018; Aug 11 (08) e007657 doi: 10.1161/CIRCIMAGING.118.007657