НОВЫЕ СИНДРОМЫ И ПАТТЕРНЫ ОСТРОЙ ОККЛЮЗИИ КОРОНАРНЫХ АРТЕРИЙ. ОБЗОР ЛИТЕРАТУРЫ.
Введение. Острый коронарный синдром остается ведущей причиной смертности и заболеваемости во всем мире, необходимости оказания неотложной помощи и скорейшего оперативного лечения. Традиционно диагноз острого коронарного синдрома основывается на клиническом анамнезе, электрокардиографических изменениях и сердечных биомаркерах, но в спектре острого коронарного синдрома существуют тонкие нетипичные проявления, которые возможно не суметь диагностировать и, следовательно не оказать необходимую помощь. Синдром Велленса и паттерн Аслангера является одним из таких примеров, при котором у пациента могут наблюдаться изменения ЭКГ, не характерные для ишемии миокарда, и даже отрицательные сердечные биомаркеры. Цель исследования. Изучить распространенность, диагностические критерии, гемодинамические показатели и тактику ведения пациентов с паттерном Аслангера и синдромом Велленса. Методы. Нами был проведен аналитический обзор руководства европейского общества кардиологов с 2020года по 2023год, а также источников в открытом доступе из научных баз данных Scopus, PubMed, Google Scholar, Web of Science, e-library. Для поиска были использованны ключевые слова: «острый коронарный синдром», «паттерн Аслангера», «синдром Велленса», «антиагрегантная терапия», «антикоагулянтная терапия». Публикации, включенные в обзор литературы, были полнотекстовые статьи на английском языке. Результаты и выводы. Всего было проанализировано 212, из них цели исследования и критериям включения соответствовали 73. Паттерн Аслангера и синдромом Велленса являются острыми коронарными синдромами высокого риска и их своевременное выявление имеет важное диагностическое и прогностическое значение. Таким образом, эти синдромы и паттерны считается эквивалентом острого инфаркта миокарда с подъемом сегмента.
Дамир Б. Бикташев1, https://orcid.org/0000-0003-4364-3586 Шолпан Т. Жукушева1, https://orcid.org/0000-0003-1902-8284 Жанар Б. Ахметова2, https://orcid.org/0000-0001-9220-5596 Сауле Ж. Кубекова1, https://orcid.org/0000-0001-5358-3690 Динара З. Садыкова1, https://orcid.org/0000-0003-3834-5648 1 НАО «Медицинский университет Астана», Кафедра внутренних болезней с курсом гастроэнтерологии, эндокринологии и пульмонологии, г. Астана, Республика Казахстан; 2. НАО «Медицинский университет Астана», Кафедра реабилитологии и спортивной медицины, г. Астана, Республика Казахстан.
1. Abbas A.E., Boura J.A., Brewington S.D., Dixon S.R., O’Neill W.W., Grines C.L. Acute angiographic analysis of non-ST-segment elevation acute myocardial infarction // Am. J. Cardiol. 2004. 94, 907–909. 2. Abulaiti A., Aini R., Xu H., Song Z. A special case of Wellens’ syndrome // J Cardiovasc Dis Res. 2013. 4(1):51-54. 3. Ahmed A.S., Kumar S. Intimidating electrocardiographic changes in an asymptomatic patient: arterial pulse tapping artifact // Indian J Clin Cardiol 2021. 2, 110−111. 4. Amsterdam E.A., Wenger N.K., Brindis R.G. et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines // Circulation. 2014. 130(25):e344-e426. 5. Arbane M., Goy J.J. Prediction of the site of total occlusion in the left anterior descending coronary artery using admission electrocardiogram in anterior wall acute myocardial infarction //. Am J Cardiol. 2000. 85:487–91. 6. Arshad S., Ferrick N.J., Monrad E.S. et al. Prevalence and association of the Wellens’ sign with coronary artery disease in an ethnically diverse urban population // J Electrocardiol. 2020. 62:211-215. 7. Aslanger E., Bjerregaard P. Mystery of “bizarre electrocardiogram” solved // J Electrocardiol. 2011, 44: 810−811. 8. Aslanger E., Yalin K. Electromechanical association: a subtle electrocardiogram artifact // J Electrocardiol. 2012. 45: 15−17. 9. Aslanger E., Yıldırımtürk Ö., Bozbeyoğlu E. et al. A simplified formula discriminating subtle anterior wall myocardial infarction from normal variant ST-segment elevation // Am J Cardiol. 2018. 122:1303-1309. 10.1016/j.amjcard.2018.06.053 10. Aslanger E., Yıldırımtürk Ö., Şimşek B. et al. A new electrocardiographic pattern indicating inferior myocardial infarction // J Electrocardiol. 2020, 61:41-46. 10.1016/j.jelectrocard.2020.04.008 11. Aslanger E. An unusual electrocardiogram artifact in a patient with near syncope // J Electrocardiol. 2010, 43: 686−688. 12. Aslanger E.K., Meyers H.P., Smith S.W. Recognizing electrocardiographically subtle occlusion myocardial infarction and differentiating it from mimics: ten steps to or away from cath lab // Turk Kardiyol Dern Ars. 2021, 49:488-500. 10.5543/tkda.2021.21026 13. Aslanger E.K., Meyers H.P., Smith S.W. Time for a new paradigm shift in myocardial infarction // Anatol J Cardiol. 2021, 25:156-162. 14. Aslanger E.K., Meyers P.H., Smith S.W. STEMI: a transitional fossil in MI classification? // J Electrocardiol. 2021, 65:163-169. 10.1016/j.jelectrocard.2021.02.001 15. Austen W.G., Edwards J.E., Frye R.L. et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association // Circulation. 1975. 51(4 suppl):5-40. 16. Bozbeyoğlu E., Aslanger E., Yıldırımtürk Ö., Şimşek B., Hünük B., Karabay C.Y. et al. The established electrocardiographic classification of anterior wall myocardial infarction misguides clinicians in terms of infarct location, extent and prognosis // Ann Noninvasive Electrocardiol. 2019. 24:e12628. 17. Bozbeyoğlu E., Aslanger E., Yıldırımtürk Ö., Şimşek B., Karabay C.Y., Türer A. et al. An algorithm for the differentiation of the infarct territory in difficult to discern electrocardiograms // J Electrocardiol. 2018. 51:1055–60. 18. Bozbeyoğlu E., Yıldırımtürk Ö., Aslanger E., Şimşek B., Karabay C.Y., Özveren O. et al. Is the inferior ST-segment elevation in anterior myocardial infarction reliable in prediction of wrap-around left anterior descending artery occlusion? // Anatol J Cardiol. 2019. 21:253–8. 19. Braunwald E., Antman E.M., Beasley J.W., et al., ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina) // J. Am. Coll. Cardiol. 36 (2000) 970–1062. 20. Chang Q., Xu Z., Fu N. et al. An unexpected ECG finding // BMJ 2023; 380: e072333. 21. Davies M.J. Coronary disease: the pathophysiology of acute coronary syndromes // Heart. 2000. 83(3):361-366. 22. Durant E., Singh A. Acute first diagonal artery occlusion: a characteristic pattern of ST-elevation in noncontiguous leads // Am J Emerg Med. 2015. 33:1326.e3-5. 23. Engelen D.J., Gorgels A.P., Cheriex E.C., De Muinck E.D., Ophuis A.J., Dassen W.R. et al. Value of the electrocardiogram in localizing the occlusion site in the left anterior descending coronary artery in acute anterior myocardial infarction // J Am Coll Cardiol. 1999. 34:389–95. 24. Fibrinolytic Therapy Trialists’ (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1000 patients // Lancet. 1994. 343: 311-22. 25. Fiol M., Carrillo A., Cygankiewicz I., Velasco J., Riera M., Bayés-Genis A. et al. A new electrocardiographic algorithm to locate the occlusion in left anterior descending coronary artery // Clin Cardiol. 2009. 32:E1–6. 26. Fiol M., Cygankiewicz I., Guindo J., Flotats A., Genis A.B., Carreras F. et al. Evolving myocardial infarction with ST elevation: ups and downs of ST in different leads identifies the culprit artery and location of the occlusion. Ann Noninvasive Electrocardiol. 2004. 9:180–6. 27. Günlü S., Demir M. Comparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: a cross-sectional study // Am J Emerg Med. 2022, 58:52-56. 10.1016/j.ajem.2022.05.021 28. Gursoy H.T., Dereagzi S.F., Caliskan U. et al. An electrocardiographic clue for pseudo-myocardial infarction due to arterial pulse-tapping artifact: Aslanger’s sign // J Innov Card Rhythm Manag. 2021. 12: 4685−4687. 29. He Y. Uncovering the truth of electromechanical association artifact with limb lead electrodes-reply // JAMA Intern Med. 2022. 182: 455. 30. Ibanez B., James S., Agewall S. et al. ESC Scientific Document Group. 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. 31. Khan A.R., Golwala H., Tripathi A. et al. Impact of total occlusion of culprit artery in acute non-ST elevation myocardial infarction: a systematic review and meta-analysis // Eur. Heart J. 2007. 38 3082–3089. 32. Khan A.R., Golwala H., Tripathi A. et al. Impact of total occlusion of culprit artery in acute non-ST elevation myocardial infarction: a systematic review and meta-analysis // Eur Heart J. 2017, 38:3082-3089.10.1093/eurheartj/ehx418 33. Kobayashi A., Misumida N., Aoi S., Kanei Y. Prevalence and clinical implication of Wellens’ sign in patients with non-ST-segment elevation myocardial infarction // Cardiol Res. 2019. 10(3):135-141. 34. Kontos M.C., Kurz M.C., Roberts C.S., et al. An evaluation of the accuracy of emergency physician activation of the cardiac catheterization laboratory for patients with suspected ST-segment elevation myocardial infarction // Ann. Emerg. Med. 2010. 55. 423–430. 35. Kontos M.C., de Lemos J.A., Deitelzweig S.B. et al. 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: a report of the American College of Cardiology Solution Set Oversight Committee // J Am Coll Cardiol. 2022, 80:1925-1960. 36. Koyama Y., Hansen P.S., Hanratty C.G., Nelson G.I., Rasmussen H.H., Prevalence of coronary occlusion and outcome of an immediate invasive strategy in suspected acute myocardial infarction with and without ST-segment elevation // Am. J. Cardiol. 2002. 90. 579–584. 37. Larson D.M., Menssen K.M., Sharkey S.W. et al. ‘‘False-positive” cardiac catheterization laboratory activation among patients with suspected STsegment elevation myocardial infarction // JAMA. 2007. 298. 2754–2760. 38. Li C., Chang Q., Yu L. et al. An electrocardiographic artifact synchronized with the cardiac rhythm: a case report // Ann Intern Med 2022. 175: 456−458. 39. Martí D., Mestre J.L., Salido L., et al. Incidence, angiographic features, and outcomes of patients presenting with subtle ST-elevation myocardial infarction // Am. Heart J. 2014. 168. 884–890. 40. Marzlin K.M. Wellens Syndrome // AACN Adv Crit Care. 2018 Fall. 29(3):360-364. 41. McCabe J.M., Armstrong E.J., Kulkarni A. et al. Prevalence and factors associated with false-positive ST-segment elevation myocardial infarction diagnoses at primary percutaneous coronary intervention-capable centers: a report from the Activate-SF registry // Arch. Intern. Med. 2012. 172 864–871. 42. Miyauchi E., Kuwazuru K., Arikawa R., Tokutake D., Chaen H., Oketani N., Ohishi M. Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria // Cureus. 2023 Jan 1. 15(1):e33227. doi: 10.7759/cureus.33227. PMID: 36601361. PMCID: PMC9805815. 43. Moore K.L., Dalley A.F., Agur A.M.R. Thorax. In: Clinically Oriented Anatomy. 7th ed. Baltimore, MD: Lippincott, Williams & Wilkins; 2014:145,148-149,160. 44. Morris N., Howard L. BET1: in patients with suspected acute coronary syndrome, does wellens’ sign on the electrocardiograph identify critical left anterior descending artery stenosis? // Emergency Medicine Journal, 2017. vol. 34, no. 4, pp. 264. 45. O’Gara P.T., Kushner F.G., Ascheim D.D. et al. ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, J. Am. Coll. Cardiol. 2013. 61. e78–e140. 46. O'Gara P.T., Kushner F.G., Ascheim D.D. et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions // Catheter Cardiovasc Interv. 2013, 82:E1-E27. 10.1002/ccd.24776 47. Ogobuiro I., Wehrle C.J., Tuma F. Anatomy, thorax, heart coronary arteries. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2022. www.ncbi.nlm.nih.gov/books/NBK534790.Accessed October 19, 2022. 48. Pendell Meyers H., Bracey A., Lee D. et al. Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction // Int J Cardiol Heart Vasc. 2021, 33:100767. 10.1016/j.ijcha.2021.100767 49. Pride Y.B., Tung P., Mohanavelu S., et al. Angiographic and clinical outcomes among patients with acute coronary syndromes presenting with isolated anterior ST-segment depressions: a TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel-Thrombolysis In Myocardial Infarction 38) substudy // JACC Cardiovasc Interv. 2010. 3 806–811. 50. Rajendran G., Muthanikkatt A.M., Nathan B. Not all waves are factual // Circulation 2021. 144: 751−753. 51. Ramanathan S., Soaly E., Cherian A., Heidous M.A. 'T' twist: Wellens syndrome // QJM. 2019 May 01/ 112(5):373-374. 52. Rehman I., Kerndt C.C., Rehman A. Anatomy, thorax, heart left anterior descending (LAD) artery. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2022. www.ncbi.nlm.nih.gov/books/ NBK482375. Accessed October 19, 2022. 53. Rhinehardt J., Brady W.J., Perron A.D., Mattu A. Electrocardiographic manifestations of Wellens’ syndrome // Am J Emerg Med. 2002. 20(7):638-643. 54. Schears M.R., Sleigh B.C., Ganti L. Wellen’s syndrome: is one electrocardiogram good and plenty? // Cureus. 2019. 11(4):e4394. 55. Schmitt C., Lehmann G., Schmieder S., Karch M., Neumann F.J., Schömig A. Diagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: limitations of ST-segment elevation in standard and extended ECG leads, Chest. 2001. 120 1540–1546. 56. Sclarovsky S., Birnbaum Y., Solodky A., Zafrir N., Wurzel M., Rechavia E. Isolated midanterior myocardial infarction: a special electrocardiographic sub-type of acute myocardial infarction consisting of ST-elevation in non-consecutive leads and two different morphologic types of ST-depression // Int J Cardiol. 1994. 46:37–47 57. Singh D., Suliman I., Chyshkevych I., Dabage N. A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male // Am J Case Rep. 2019 Jan 28. 20:117-120. 58. Smilowitz N.R., Galloway A.C., Ohman E.M., Rao S.V., Bangalore S., Katz S.D., Hochman J.S. Coronary revascularization and circulatory support strategies in patients with myocardial infarction, multi-vessel coronary artery disease, and cardiogenic shock: insights from an international survey // Am Heart J. 2020, 225:55-59. 10.1016/j.ahj.2020.04.011 59. Suryawan I.G.R., Bakhriansyah J., Puspitasari M., et al. To reperfuse or not to reperfuse: a case report of Wellens’ syndrome with suspected COVID-19 infection // Egypt Heart J. 2020. 72:58 60. Taglieri N., Saia F., Alessi L., Cinti L., Reggiani M.L., Lorenzini M. et al. Diagnostic performance of standard electrocardiogram for prediction of infarct related artery and site of coronary occlusion in unselected STEMI patients undergoing primary percutaneous coronary intervention // Eur Heart J Acute Cardiovasc Care. 2014. 3:326–39. 61. Tahvanainen M., Nikus K.C., Holmvang L. et al. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction // J Electrocardiol. 2011, 44:495-501.10.1016/j.jelectrocard. 2011.04.005 62. Takahashi K., Morioka H., Uemura S. et al. Aslanger ’s sign in 12-lead electrocardiogram // Oxf Med Case Rep 2023. 2023: omad017. 63. Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A., White H.D. Fourth universal definition of myocardial infarction // J Am Coll Cardiol. 2018, 72:2231-2264. 10.1016/j.jacc.2018.08.1038 64. Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A., White H.D. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction // J Am Coll Cardiol. 2018. 72: 2231-2264. 65. Thygesen K., Alpert J.S., Jaffe A.S. et al. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/ American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction // J. Am. Coll. Cardiol. 2018. 72. 2231–2264. 66. Van deWerf А. The history of coronary reperfusion // Eur. Heart J. 2014. 35 2510–251 67. Wang T.Y., Zhang M., Fu Y. et al. Incidence, distribution, and prognostic impact of occluded culprit arteries among patients with non-ST-elevation acute coronary syndromes undergoing diagnostic angiography // Am. Heart J. 2009. 157. 716–723. 68. Wang X., Sun J., Feng Z., Gao Y., Sun C., Li G. Two case reports of Wellens' syndrome // J Int Med Res. 2018 Nov. 46(11):4845-4851. 69. Weber C., Brown K.N., Borger J. Anatomy, thorax, heart anomalous left anterior descending (LAD) artery. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2022. www.ncbi.nlm.nih.gov/books/NBK538162. Accessed October 19, 2022. 70. Wellen's syndrome: a rare case. Nagdev G., Chavan G., Aurangabadkar G.M. http://10.7759/cureus.25158 // Cureus. 2022. 14:0. 71. Zhelev Z., Hyde C., Youngman E. et al. Diagnostic accuracy of single baseline measurement of Elecsys Troponin T high-sensitive assay for diagnosis of acute myocardial infarction in emergency department: systematic review and meta-analysis // BMJ. 2015, 350:h15. 10.1136/bmj.h15 72. Zhou L., Gong X., Chen H., et al. Characteristics of Wellens' Syndrome in the Current PCI Era: A Single-Center Retrospective Study // Emerg Med Int. 2023 Mar 24. 2023:8865553. doi: 10.1155/2023/8865553. PMID: 37008757; PMCID: PMC10065856. 73. Zhou L., Gong X., et al. Wellens’ syndrome: incidence, characteristics, and long-term clinical outcomes // BMC Cardiovascular Disorders. 2022. 22:176–178. doi:10.1186/s12872-022-02560-6.
Количество просмотров: 191

Ключевые слова:

Библиографическая ссылка

Бикташев Д.Б., Жукушева Ш.Т., Ахметова Ж.Б., Кубекова С.Ж., Садыкова Д.З. Новые синдромы и паттерны острой окклюзии коронарных артерий. Обзор литературы // Наука и Здравоохранение. 2023. 6(Т.25). С. 171-180. DOI 10.34689/SH.2023.25.6.020

Авторизируйтесь для отправки комментариев