russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2020-2-3649russjcardiol-3649Research ArticleМЕТОДЫ ИССЛЕДОВАНИЯMETHODS OF STUDYОценка миокардиального кровотока и резерва – физиологические основы и клиническое значение перфузионной сцинтиграфии в обследовании пациентов с хроническим коронарным синдромомEvaluation of myocardial blood flow and coronary flow reserve — the physiological foundation and clinical significance of myocardial perfusion scintigraphy in the examination of patients with chronic coronary syndromehttps://orcid.org/0000-0003-0883-466XМочулаА. В.MochulaA. V.

Мочула Андрей Викторович — кандидат медицинских наук, научный сотрудник лаборатории радионуклидных методов исследования

Томск 

SPIN-код: 7635-6558.

mochula.andrew@gmail.comhttps://orcid.org/0000-0002-1311-0378МальцеваА. Н.MaltsevaA. N.

Мальцева Алина Николаевна — клинический ординатор лаборатории радионуклидных методов исследования

Томск

SPIN-код: 6213-3736.

maltseva.alina.93@gmail.comhttps://orcid.org/0000-0001-9887-8214ШипулинВ. В.ShipulinV. V.

Шипулин Владимир Владимирович — аспирант лаборатории радионуклидных методов исследования

Томск

SPIN-код: 8146-7942.

shipartphoto@gmail.comhttps://orcid.org/0000-0002-1513-8614ЗавадовскийК. В.ZavadovskyK. V.

Завадовский Константин Валерьевич — доктор медицинских наук, заведующий лабораторией радионуклидных методов исследования

Томск

SPIN-код: 5081-3495.

konstzav@gmail.comФГБНУ Томский национальный исследовательский медицинский центр Российской академии наук, Научно-исследовательский институт кардиологииРоссияTomsk National Research Medical Center, Cardiology Research InstituteRussian Federation20201112201925236493649Copyright © Мочула А.В., Мальцева А.Н., Шипулин В.В., Завадовский К.В., 20202020Мочула А.В., Мальцева А.Н., Шипулин В.В., Завадовский К.В.Mochula A.V., Maltseva A.N., Shipulin V.V., Zavadovsky K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/3649

В обследовании пациентов с хроническим коронарным синдромом важное значение имеют неинвазивные визуализирующие тесты, среди которых позитронная эмиссионная томография (ПЭТ) обладает наиболее высокими показателями диагностической точности и прогностической значимости. Это обусловлено возможностью данного метода оценивать миокардиальной кровоток (МК) и резерв коронарного кровотока (РКК) — физиологические процессы, обеспечивающие потребность миокарда в кислороде, как в условиях покоя, так и при нагрузке, а также поддержания достаточного кровоснабжения миокарда при наличии сужений коронарных артерий. В то же время, высокая стоимость и низкая доступность ПЭТ исследований МК и РКК, не позволяют широко использовать данный подход в клинической практике. Применение современных гамма-камер, с детекторами на основе кадмий-цинк-теллурида, может выступить альтернативой ПЭТ при невозможности проведения последней. Целью обзора является представление сведений фундаментального характера о МК и РКК, а также о современных возможностях сцинтиграфического определения данных индексов и их клинической значимости.

Non-invasive cardiovascular imaging plays an important role in examination of patients with chronic coronary syndrome. Positron emission tomography (PET) has the highest diagnostic accuracy and prognostic significance due to the ability to assess myocardial blood flow (MBF) and coronary flow reserve (CFR). These physiological processes provide myocardial oxygen demand, both at rest and stress, as well as maintaining sufficient myocardial circulation during coronary artery constriction. At the same time, the high cost and low availability of assessing MBF and CFR by PET do not allow widespread use of this approach in clinical practice. The use of modern gamma cameras with cadmium zinc telluride detectors can be an alternative to PET. The aim of the review is to present fundamental information about MBF and CFR, as well as about the possibilities of using scintigraphy for determination of these parameters and their clinical significance.

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The authors declare that there are no conflicts of interest present.